SB249: Bill Text

SB249,67 Section 67 . 343.16 (5) (a) of the statutes is amended to read:

SB249,34,16 343.16 (5) (a) The secretary may require any applicant for a license or any licensed operator to submit to a special examination by such persons or agencies as the secretary may direct to determine incompetency, physical or mental disability, disease, or any other condition that might prevent such applicant or licensed person from exercising reasonable and ordinary control over a motor vehicle. If the department requires the applicant to submit to an examination, the applicant shall pay for the examination. If the department receives an application for a renewal or duplicate license after voluntary surrender under s. 343.265 or receives a report from a physician, physician assistant, as defined in s. 448.01 (6), advanced practice registered nurse prescriber certified under s. 441.16 (2) licensed under s. 441.09, or optometrist under s. 146.82 (3), or if the department has a report of 2 or more arrests within a one-year period for any combination of violations of s. 346.63 (1) or (5) or a local ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the offense involved the use of a vehicle, the department shall determine, by interview or otherwise, whether the operator should submit to an examination under this section. The examination may consist of an assessment. If the examination indicates that education or treatment for a disability, disease or condition concerning the use of alcohol, a controlled substance or a controlled substance analog is appropriate, the department may order a driver safety plan in accordance with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety plan, the department shall revoke the person's operating privilege in the manner specified in s. 343.30 (1q) (d).

SB249,68 Section 68 . 343.51 (1) of the statutes is amended to read:

SB249,35,14 343.51 (1) Any person who qualifies for registration plates of a special design under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that limits or impairs the ability to walk may request from the department a special identification card that will entitle any motor vehicle parked by, or under the direction of, the person, or a motor vehicle operated by or on behalf of the organization when used to transport such a person, to parking privileges under s. 346.50 (2), (2a), and (3). The department shall issue the card at a fee to be determined by the department, upon submission by the applicant, if the applicant is an individual rather than an organization, of a statement from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal that the person is a person with a disability that limits or impairs the ability to walk. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice registered nurse, public health nurse, physician assistant, podiatrist, chiropractor, or practitioner as to the duration of the disability. The department shall issue the card upon application by an organization on a form prescribed by the department if the department believes that the organization meets the requirements under this subsection.

SB249,69 Section 69 . 343.62 (4) (a) 4. of the statutes is amended to read:

SB249,35,24 343.62 (4) (a) 4. The applicant submits with the application a statement completed within the immediately preceding 24 months, except as provided by rule, by a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state, and listed in the Christian Science journal certifying that, in the medical care provider's judgment, the applicant is physically fit to teach driving.

SB249,70 Section 70 . 440.03 (13) (b) 3. of the statutes is amended to read:

SB249,36,2 440.03 (13) (b) 3. Advanced practice registered nurse prescriber permitted to issue prescription orders.

SB249,71 Section 71. 440.03 (13) (b) 39m. of the statutes is created to read:

SB249,36,4 440.03 (13) (b) 39m. Nurse, advanced practice registered.

SB249,72 Section 72. 440.03 (13) (b) 42. of the statutes is repealed.

SB249,73 Section 73 . 440.08 (2) (a) 4m. of the statutes is amended to read:

SB249,36,8 440.08 (2) (a) 4m. Advanced practice registered nurse prescriber: October permitted to issue prescription orders: March 1 of each even-numbered year.

SB249,74 Section 74. 440.08 (2) (a) 47. of the statutes is created to read:

SB249,36,11 440.08 (2) (a) 47. Nurse, advanced practice registered: March 1 of each even-numbered year.

SB249,75 Section 75. 440.08 (2) (a) 50. of the statutes is repealed.

SB249,76 Section 76 . 440.981 (1) of the statutes is amended to read:

SB249,36,18 440.981 (1) No person may use the title “licensed midwife," describe or imply that he or she is a licensed midwife, or represent himself or herself as a licensed midwife unless the person is granted a license under this subchapter or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09.

SB249,77 Section 77 . 440.982 (1) of the statutes is amended to read:

SB249,36,24 440.982 (1) No person may engage in the practice of midwifery unless the person is granted a license under this subchapter, is granted a temporary permit pursuant to a rule promulgated under s. 440.984 (2m), or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09.

SB249,78 Section 78 . 440.987 (2) of the statutes is amended to read:

SB249,37,4 440.987 (2) One member who is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09 and who practices in an out-of-hospital setting.

SB249,79 Section 79 . 441.001 (1c) of the statutes is created to read:

SB249,37,11 441.001 (1c) Advanced practice registered nursing. “Advanced practice registered nursing” means the advanced practice of nursing in one of the 4 recognized roles based on advanced clinical knowledge and skills focusing on direct care of individuals, greater responsibility, autonomy, and accountability for the provision of care, health promotion and maintenance, including prescribing pharmacological agents and therapeutics, and management of patient conditions.

SB249,80 Section 80 . 441.001 (1m) of the statutes is created to read:

SB249,37,20 441.001 (1m) Clinical pharmacology or therapeutics. “Clinical pharmacology or therapeutics” means the identification of individual and classes of drugs, their indications and contraindications, their efficacy, their side effects, and their interactions, as well as clinical judgment skills and decision-making based on thorough interviewing, history taking, physical assessment, test selection and interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation, and nonpharmacological interventions.

SB249,81 Section 81 . 441.001 (5) of the statutes is created to read:

SB249,37,23 441.001 (5) Recognized role. “Recognized role” means one of the following roles:

SB249,37,24 (a) Certified nurse-midwife.

SB249,37,25 (b) Certified registered nurse anesthetist.

SB249,38,1 (c) Clinical nurse specialist.

SB249,38,2 (d) Nurse practitioner.

SB249,82 Section 82 . 441.01 (3) of the statutes is amended to read:

SB249,38,10 441.01 (3) The board may promulgate rules to establish minimum standards for schools for professional nurses and, schools for licensed practical nurses, and schools for advanced practice registered nurses, including all related clinical units and facilities, and make and provide periodic surveys and consultations to such schools. It The board may also establish promulgate rules to prevent unauthorized persons from practicing professional nursing. It shall approve all rules for the administration of this chapter in accordance with ch. 227.

SB249,83 Section 83 . 441.01 (4) of the statutes is amended to read:

SB249,38,17 441.01 (4) The board shall direct that those schools that qualify be placed on a list of schools the board has approved for professional nurses or, of schools the board has approved for licensed practical nurses, or of schools the board has approved for advanced practice registered nurses on application and proof of qualifications;, and the board shall make a study of nursing education and initiate promulgate rules and policies to improve it.

SB249,84 Section 84 . 441.01 (7) (a) (intro.) of the statutes is amended to read:

SB249,38,22 441.01 (7) (a) (intro.) The board shall require each applicant for the renewal of a registered nurse or, licensed practical nurse, or advanced practice registered license issued under this chapter to do all of the following as a condition for renewing the license:

SB249,85 Section 85 . 441.01 (7) (b) of the statutes is amended to read:

SB249,39,5 441.01 (7) (b) The board may not renew a registered nurse or, licensed practical nurse, or advanced practice registered license under this chapter unless the renewal applicant has completed the nursing workforce survey to the satisfaction of the board. The board shall establish standards to determine whether the survey has been completed. The board shall, by no later than June 30 of each odd-numbered year, submit all completed nursing workforce survey forms to the department of workforce development.

SB249,86 Section 86 . 441.01 (7) (c) of the statutes is created to read:

SB249,39,9 441.01 (7) (c) An applicant who is renewing both a registered nurse and advanced practice registered nurse license under s. 441.09 (1) (d) is only required to pay a single fee under par. (a) 2.

SB249,87 Section 87 . 441.06 (title) of the statutes is repealed and recreated to read:

SB249,39,11 441.06 (title) Registered nurses; civil liability exemption.

SB249,88 Section 88. 441.06 (3) of the statutes is amended to read:

SB249,39,18 441.06 (3) A Except as provided in s. 441.09 (1) (d), a registered nurse practicing for compensation shall, on or before the applicable renewal date specified under s. 440.08 (2) (a), submit to the board on furnished forms a statement giving name, residence, and other facts that the board requires, with the nursing workforce survey and fee required under s. 441.01 (7) and the applicable renewal fee determined by the department under s. 440.03 (9) (a).

SB249,89 Section 89 . 441.06 (4) of the statutes is amended to read:

SB249,40,3 441.06 (4) Except as provided in s. 257.03, no person may practice or attempt to practice professional nursing, nor use the title, letters, or anything else to indicate that he or she is a registered or professional nurse unless he or she is licensed under this section. Except as provided in s. 257.03, no person not so licensed may use in connection with his or her nursing employment or vocation any title or anything else to indicate that he or she is a trained, certified or graduate nurse. This subsection does not apply to any registered nurse who holds a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted the enhanced nurse licensure compact under s. 441.51.

SB249,90 Section 90. 441.06 (7) of the statutes is renumbered 441.09 (7) and amended to read:

SB249,40,8 441.09 (7) Civil liability. No person certified licensed as an advanced practice registered nurse prescriber under s. 441.16 (2) this section is liable for civil damages for any of the following:

SB249,40,13 (a) Reporting in good faith to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment impairs the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB249,40,18 (b) In good faith, not reporting to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment does not impair the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB249,91 Section 91. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended to read:

SB249,41,4 441.07 (1g) (intro.) Subject to the rules promulgated under s. 440.03 (1), the board may deny an initial license or revoke, limit, suspend, or deny the renewal of a license of a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse; deny an initial certificate permit to issue prescription orders under s. 441.09 (2) or revoke, limit, suspend, or deny the renewal of a certificate permit to prescribe drugs or devices granted under s. 441.16 issue prescription orders; or reprimand a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse, if the board finds that the applicant or licensee committed any of the following:

SB249,41,5 (a) Fraud in the procuring or renewal of the certificate permit or license.

SB249,41,8 (c) Acts which that show the registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse to be unfit or incompetent by reason of negligence, abuse of alcohol or other drugs, or mental incompetency.

SB249,41,11 (e) A violation of any state or federal law that regulates prescribing or dispensing drugs or devices, if the person has holds a certificate permit to prescribe drugs or devices under s. 441.16 issue prescription orders under s. 441.09 (2).

SB249,92 Section 92. 441.09 of the statutes is created to read:

SB249,41,16 441.09 Advanced practice registered nurses; civil liability exemption. (1) License. (a) An applicant who satisfies all of the following requirements may apply to the board for initial licensure by the board as an advanced practice registered nurse:

SB249,41,17 1. The applicant satisfies one of the following criteria:

SB249,41,19 a. The applicant holds a valid license to practice as a registered nurse issued under s. 441.06 (1), (1c), or (1m).

SB249,41,21 b. The applicant applies concurrently for a license under s. 441.06 (1), (1c), or (1m) with the application for a license under this paragraph.

SB249,41,24 c. The applicant is a registered nurse who holds a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted the nurse licensure compact.

SB249,42,2 2. The applicant provides evidence satisfactory to the board that he or she satisfies one of the following criteria:

SB249,42,7 a. The applicant has completed a graduate-level or postgraduate-level education program that is approved by the board and that prepares the applicant for the practice of advanced practice registered nursing in one of the 4 recognized roles, and the applicant holds a current certification by a national certifying body approved by the board.

SB249,42,11 b. On January 1, 2017, the applicant was licensed as a registered nurse in this state and was practicing in a recognized role, and the applicant satisfies additional criteria established by the board by rule under this subd. 2. b. relating to practice, education, or certification.

SB249,42,12 3. The applicant pays the fee specified under s. 440.05 (1).

SB249,42,14 4. The applicant provides evidence of any malpractice liability insurance coverage required under sub. (5).

SB249,42,18 5. If the applicant is applying to receive a certified nurse-midwife specialty designation under par. (c) 1. a., the applicant provides evidence satisfactory to the board that the applicant is currently certified by a national certifying body approved by the board.

SB249,42,20 6. The applicant does not have an arrest or conviction record, subject to ss. 111.321, 111.322, and 111.335.

SB249,42,22 7. The applicant meets any other criteria established by the board by rule relating to the education, training, or experience required for each recognized role.

SB249,43,2 (b) An applicant who satisfies the requirements established by the board under sub. (6) (c) may, concurrently with his or her application for an advanced practice registered nurse under par. (a) and upon payment of the additional fee required for the permit under sub. (2) (b) 3., apply for a permit to issue prescription orders under sub. (2).

SB249,43,6 (c) 1. Subject to subd. 3. and s. 441.07 (1g), the board shall grant an advanced practice registered nurse license to an applicant the board determines meets the requirements under par. (a). The board shall also grant a person who is granted a license all of the following:

SB249,43,9 a. One or more specialty designations corresponding to the recognized roles for which the board determines that the person qualifies based on the person's qualifications under par. (a).

SB249,43,12 b. A permit to issue prescription orders under sub. (2), if the applicant applies for a permit under par. (b) and the board determines the applicant satisfies the requirements under sub. (6) (c).

SB249,43,14 2. Each specialty designation granted under subd. 1. a. shall appear on the person's advanced practice registered nurse license.

SB249,43,17 3. The board may not grant an advanced practice registered nurse license to a person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless the board also grants the person the license under s. 441.06 (1), (1c), or (1m).

SB249,43,19 4. The board may place specific limitations on a person licensed as an advanced practice registered nurse as a condition of licensure.

SB249,44,7 (d) On or before the applicable renewal date specified under s. 440.08 (2) (a), an advanced practice registered nurse shall submit to the board on a form furnished by the board a statement giving his or her name and residence, the nursing workforce survey and fee required under s. 441.01 (7), evidence of having satisfied the continuing education requirements under sub. (4), evidence of any malpractice liability insurance coverage required under sub. (5), current evidence that the person satisfies each of the requirements under par. (a) 1., 2., 5., and 7. that apply with respect to the person, and any other information that the board requires by rule, with the applicable renewal fee determined by the department under s. 440.03 (9) (a). The board shall grant to a person who satisfies the requirements under this paragraph the renewal of his or her advanced practice registered nurse license and specialty designations granted under par. (c) 1. a. and shall, if the person holds a license under s. 441.06 (1), (1c), or (1m), also grant the renewal of that license.

SB249,44,9 (2) Permit to issue prescription orders. (a) In this subsection, “prescription order” has the meaning given in s. 450.01 (21).

SB249,44,11 (b) Subject to s. 441.07 (1g), the board shall grant a permit to issue prescription orders to an applicant who satisfies all of the following:

SB249,44,15 1. The applicant is licensed as an advanced practice registered nurse under sub. (1) or the applicant applies for the permit under sub. (1) (b) concurrently with his or her application for a license under sub. (1) (a) and is granted the license under sub. (1) (c).

SB249,44,17 2. The applicant meets the additional requirements for granting the permit established by the board under sub. (6) (c).

SB249,44,18 3. The applicant pays the fee specified under s. 440.05 (1).

SB249,44,25 (c) On or before the applicable renewal date specified under s. 440.08 (2) (a), a person issued a permit under par. (b) shall submit to the board on a form furnished by the board a statement giving his or her name and residence and any other information that the board requires by rule with the applicable renewal fee determined by the department under s. 440.03 (9) (a). The board shall grant to a person who satisfies the requirements under this paragraph the renewal of his or her permit to issue prescription orders.

SB249,45,4 (d) An advanced practice registered nurse who holds a permit under this subsection may issue prescription orders, subject to the rules promulgated under sub. (6) (a) and (d), and may provide expedited partner therapy in the manner described in s. 448.035.

SB249,45,7 (3) Practice; titles. (a) 1. The holder of a license issued under this section is an “advanced practice registered nurse," may append to his or her name the title “A.P.R.N.," and is authorized to practice advanced practice registered nursing.

SB249,45,10 2. The holder of a specialty designation for a recognized role granted under sub. (1) (c) 1. a. may append to his or her name the title and an abbreviation corresponding to that recognized role.

SB249,45,15 (b) 1. Except as provided in par. (d) and s. 257.03, no person may practice or attempt to practice advanced practice registered nursing, nor use the title “advanced practice registered nurse," the title “A.P.R.N.," or anything else to indicate that he or she is an advanced practice registered nurse unless he or she is licensed under this section.