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SB249,37,4
1440.987 (2) One member who is licensed as a nurse-midwife under s. 441.15
2an advanced practice registered nurse and possesses a certified nurse-midwife
3specialty designation under s. 441.09
and who practices in an out-of-hospital
4setting.
SB249,79 5Section 79 . 441.001 (1c) of the statutes is created to read:
SB249,37,116 441.001 (1c) Advanced practice registered nursing. “Advanced practice
7registered nursing” means the advanced practice of nursing in one of the 4 recognized
8roles based on advanced clinical knowledge and skills focusing on direct care of
9individuals, greater responsibility, autonomy, and accountability for the provision of
10care, health promotion and maintenance, including prescribing pharmacological
11agents and therapeutics, and management of patient conditions.
SB249,80 12Section 80 . 441.001 (1m) of the statutes is created to read:
SB249,37,2013 441.001 (1m) Clinical pharmacology or therapeutics. “Clinical
14pharmacology or therapeutics” means the identification of individual and classes of
15drugs, their indications and contraindications, their efficacy, their side effects, and
16their interactions, as well as clinical judgment skills and decision-making based on
17thorough interviewing, history taking, physical assessment, test selection and
18interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation
19of conditions, treatment decisions, case evaluation, and nonpharmacological
20interventions.
SB249,81 21Section 81 . 441.001 (5) of the statutes is created to read:
SB249,37,2322 441.001 (5) Recognized role. “Recognized role” means one of the following
23roles:
SB249,37,2424 (a) Certified nurse-midwife.
SB249,37,2525 (b) Certified registered nurse anesthetist.
SB249,38,1
1(c) Clinical nurse specialist.
SB249,38,22 (d) Nurse practitioner.
SB249,82 3Section 82 . 441.01 (3) of the statutes is amended to read:
SB249,38,104 441.01 (3) The board may promulgate rules to establish minimum standards
5for schools for professional nurses and, schools for licensed practical nurses, and
6schools for advanced practice registered nurses,
including all related clinical units
7and facilities, and make and provide periodic surveys and consultations to such
8schools. It The board may also establish promulgate rules to prevent unauthorized
9persons from practicing professional nursing. It shall approve all rules for the
10administration of this chapter in accordance with ch. 227.
SB249,83 11Section 83 . 441.01 (4) of the statutes is amended to read:
SB249,38,1712 441.01 (4) The board shall direct that those schools that qualify be placed on
13a list of schools the board has approved for professional nurses or, of schools the board
14has approved for licensed practical nurses, or of schools the board has approved for
15advanced practice registered nurses
on application and proof of qualifications;, and
16the board shall make a study of nursing education and initiate promulgate rules and
17policies to improve it.
SB249,84 18Section 84 . 441.01 (7) (a) (intro.) of the statutes is amended to read:
SB249,38,2219 441.01 (7) (a) (intro.) The board shall require each applicant for the renewal
20of a registered nurse or, licensed practical nurse, or advanced practice registered
21license issued under this chapter to do all of the following as a condition for renewing
22the license:
SB249,85 23Section 85 . 441.01 (7) (b) of the statutes is amended to read:
SB249,39,524 441.01 (7) (b) The board may not renew a registered nurse or, licensed practical
25nurse, or advanced practice registered license under this chapter unless the renewal

1applicant has completed the nursing workforce survey to the satisfaction of the
2board. The board shall establish standards to determine whether the survey has
3been completed. The board shall, by no later than June 30 of each odd-numbered
4year, submit all completed nursing workforce survey forms to the department of
5workforce development.
SB249,86 6Section 86 . 441.01 (7) (c) of the statutes is created to read:
SB249,39,97 441.01 (7) (c) An applicant who is renewing both a registered nurse and
8advanced practice registered nurse license under s. 441.09 (1) (d) is only required to
9pay a single fee under par. (a) 2.
SB249,87 10Section 87 . 441.06 (title) of the statutes is repealed and recreated to read:
SB249,39,11 11441.06 (title) Registered nurses; civil liability exemption.
SB249,88 12Section 88. 441.06 (3) of the statutes is amended to read:
SB249,39,1813 441.06 (3) A Except as provided in s. 441.09 (1) (d), a registered nurse
14practicing for compensation shall, on or before the applicable renewal date specified
15under s. 440.08 (2) (a), submit to the board on furnished forms a statement giving
16name, residence, and other facts that the board requires, with the nursing workforce
17survey and fee required under s. 441.01 (7) and the applicable renewal fee
18determined by the department under s. 440.03 (9) (a).
SB249,89 19Section 89 . 441.06 (4) of the statutes is amended to read:
SB249,40,320 441.06 (4) Except as provided in s. 257.03, no person may practice or attempt
21to practice professional nursing, nor use the title, letters, or anything else to indicate
22that he or she is a registered or professional nurse unless he or she is licensed under
23this section. Except as provided in s. 257.03, no person not so licensed may use in
24connection with his or her nursing employment or vocation any title or anything else
25to indicate that he or she is a trained, certified or graduate nurse. This subsection

1does not apply to any registered nurse who holds a multistate license, as defined in
2s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted the
3enhanced nurse licensure compact under s. 441.51.
SB249,90 4Section 90. 441.06 (7) of the statutes is renumbered 441.09 (7) and amended
5to read:
SB249,40,86 441.09 (7) Civil liability. No person certified licensed as an advanced practice
7registered nurse prescriber under s. 441.16 (2) this section is liable for civil damages
8for any of the following:
SB249,40,139 (a) Reporting in good faith to the department of transportation under s. 146.82
10(3) a patient's name and other information relevant to a physical or mental condition
11of the patient that in the advanced practice nurse prescriber's registered nurse's
12judgment impairs the patient's ability to exercise reasonable and ordinary control
13over a motor vehicle.
SB249,40,1814 (b) In good faith, not reporting to the department of transportation under s.
15146.82 (3) a patient's name and other information relevant to a physical or mental
16condition of the patient that in the advanced practice nurse prescriber's registered
17nurse's
judgment does not impair the patient's ability to exercise reasonable and
18ordinary control over a motor vehicle.
SB249,91 19Section 91. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended to
20read:
SB249,41,421 441.07 (1g) (intro.) Subject to the rules promulgated under s. 440.03 (1), the
22board may deny an initial license or revoke, limit, suspend, or deny the renewal of
23a license of a registered nurse, nurse-midwife advanced practice registered nurse,
24or licensed practical nurse; deny an initial certificate permit to issue prescription
25orders under s. 441.09 (2)
or revoke, limit, suspend, or deny the renewal of a

1certificate permit to prescribe drugs or devices granted under s. 441.16 issue
2prescription orders
; or reprimand a registered nurse, nurse-midwife advanced
3practice registered nurse
, or licensed practical nurse, if the board finds that the
4applicant or licensee committed any of the following:
SB249,41,55 (a) Fraud in the procuring or renewal of the certificate permit or license.
SB249,41,86 (c) Acts which that show the registered nurse, nurse-midwife advanced
7practice registered nurse,
or licensed practical nurse to be unfit or incompetent by
8reason of negligence, abuse of alcohol or other drugs, or mental incompetency.
SB249,41,119 (e) A violation of any state or federal law that regulates prescribing or
10dispensing drugs or devices, if the person has holds a certificate permit to prescribe
11drugs or devices under s. 441.16
issue prescription orders under s. 441.09 (2).
SB249,92 12Section 92. 441.09 of the statutes is created to read:
SB249,41,16 13441.09 Advanced practice registered nurses; civil liability exemption.
14(1)
License. (a) An applicant who satisfies all of the following requirements may
15apply to the board for initial licensure by the board as an advanced practice
16registered nurse:
SB249,41,1717 1. The applicant satisfies one of the following criteria:
SB249,41,1918 a. The applicant holds a valid license to practice as a registered nurse issued
19under s. 441.06 (1), (1c), or (1m).
SB249,41,2120 b. The applicant applies concurrently for a license under s. 441.06 (1), (1c), or
21(1m) with the application for a license under this paragraph.
SB249,41,2422 c. The applicant is a registered nurse who holds a multistate license, as defined
23in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted
24the nurse licensure compact.
SB249,42,2
12. The applicant provides evidence satisfactory to the board that he or she
2satisfies one of the following criteria:
SB249,42,73 a. The applicant has completed a graduate-level or postgraduate-level
4education program that is approved by the board and that prepares the applicant for
5the practice of advanced practice registered nursing in one of the 4 recognized roles,
6and the applicant holds a current certification by a national certifying body approved
7by the board.
SB249,42,118 b. On January 1, 2017, the applicant was licensed as a registered nurse in this
9state and was practicing in a recognized role, and the applicant satisfies additional
10criteria established by the board by rule under this subd. 2. b. relating to practice,
11education, or certification.
SB249,42,1212 3. The applicant pays the fee specified under s. 440.05 (1).
SB249,42,1413 4. The applicant provides evidence of any malpractice liability insurance
14coverage required under sub. (5).
SB249,42,1815 5. If the applicant is applying to receive a certified nurse-midwife specialty
16designation under par. (c) 1. a., the applicant provides evidence satisfactory to the
17board that the applicant is currently certified by a national certifying body approved
18by the board.
SB249,42,2019 6. The applicant does not have an arrest or conviction record, subject to ss.
20111.321, 111.322, and 111.335.
SB249,42,2221 7. The applicant meets any other criteria established by the board by rule
22relating to the education, training, or experience required for each recognized role.
SB249,43,223 (b) An applicant who satisfies the requirements established by the board under
24sub. (6) (c) may, concurrently with his or her application for an advanced practice
25registered nurse under par. (a) and upon payment of the additional fee required for

1the permit under sub. (2) (b) 3., apply for a permit to issue prescription orders under
2sub. (2).
SB249,43,63 (c) 1. Subject to subd. 3. and s. 441.07 (1g), the board shall grant an advanced
4practice registered nurse license to an applicant the board determines meets the
5requirements under par. (a). The board shall also grant a person who is granted a
6license all of the following:
SB249,43,97 a. One or more specialty designations corresponding to the recognized roles for
8which the board determines that the person qualifies based on the person's
9qualifications under par. (a).
SB249,43,1210 b. A permit to issue prescription orders under sub. (2), if the applicant applies
11for a permit under par. (b) and the board determines the applicant satisfies the
12requirements under sub. (6) (c).
SB249,43,1413 2. Each specialty designation granted under subd. 1. a. shall appear on the
14person's advanced practice registered nurse license.
SB249,43,1715 3. The board may not grant an advanced practice registered nurse license to
16a person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless
17the board also grants the person the license under s. 441.06 (1), (1c), or (1m).
SB249,43,1918 4. The board may place specific limitations on a person licensed as an advanced
19practice registered nurse as a condition of licensure.
SB249,44,720 (d) On or before the applicable renewal date specified under s. 440.08 (2) (a),
21an advanced practice registered nurse shall submit to the board on a form furnished
22by the board a statement giving his or her name and residence, the nursing workforce
23survey and fee required under s. 441.01 (7), evidence of having satisfied the
24continuing education requirements under sub. (4), evidence of any malpractice
25liability insurance coverage required under sub. (5), current evidence that the person

1satisfies each of the requirements under par. (a) 1., 2., 5., and 7. that apply with
2respect to the person, and any other information that the board requires by rule, with
3the applicable renewal fee determined by the department under s. 440.03 (9) (a). The
4board shall grant to a person who satisfies the requirements under this paragraph
5the renewal of his or her advanced practice registered nurse license and specialty
6designations granted under par. (c) 1. a. and shall, if the person holds a license under
7s. 441.06 (1), (1c), or (1m), also grant the renewal of that license.
SB249,44,9 8(2) Permit to issue prescription orders. (a) In this subsection, “prescription
9order” has the meaning given in s. 450.01 (21).
SB249,44,1110 (b) Subject to s. 441.07 (1g), the board shall grant a permit to issue prescription
11orders to an applicant who satisfies all of the following:
SB249,44,1512 1. The applicant is licensed as an advanced practice registered nurse under
13sub. (1) or the applicant applies for the permit under sub. (1) (b) concurrently with
14his or her application for a license under sub. (1) (a) and is granted the license under
15sub. (1) (c).
SB249,44,1716 2. The applicant meets the additional requirements for granting the permit
17established by the board under sub. (6) (c).
SB249,44,1818 3. The applicant pays the fee specified under s. 440.05 (1).
SB249,44,2519 (c) On or before the applicable renewal date specified under s. 440.08 (2) (a),
20a person issued a permit under par. (b) shall submit to the board on a form furnished
21by the board a statement giving his or her name and residence and any other
22information that the board requires by rule with the applicable renewal fee
23determined by the department under s. 440.03 (9) (a). The board shall grant to a
24person who satisfies the requirements under this paragraph the renewal of his or her
25permit to issue prescription orders.
SB249,45,4
1(d) An advanced practice registered nurse who holds a permit under this
2subsection may issue prescription orders, subject to the rules promulgated under
3sub. (6) (a) and (d), and may provide expedited partner therapy in the manner
4described in s. 448.035.
SB249,45,7 5(3) Practice; titles. (a) 1. The holder of a license issued under this section is
6an “advanced practice registered nurse," may append to his or her name the title
7“A.P.R.N.," and is authorized to practice advanced practice registered nursing.
SB249,45,108 2. The holder of a specialty designation for a recognized role granted under sub.
9(1) (c) 1. a. may append to his or her name the title and an abbreviation corresponding
10to that recognized role.
SB249,45,1511 (b) 1. Except as provided in par. (d) and s. 257.03, no person may practice or
12attempt to practice advanced practice registered nursing, nor use the title “advanced
13practice registered nurse," the title “A.P.R.N.," or anything else to indicate that he
14or she is an advanced practice registered nurse unless he or she is licensed under this
15section.
SB249,45,1616 2. Except as provided in s. 257.03, no person may do any of the following:
SB249,45,1917 a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else
18to indicate that he or she is a certified nurse-midwife unless he or she has been
19granted a certified nurse-midwife specialty designation under sub. (1) (c) 1. a.
SB249,45,2320 b. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or
21anything else to indicate that he or she is a certified registered nurse anesthetist
22unless he or she has been granted a certified registered nurse anesthetist specialty
23designation under sub. (1) (c) 1. a.
SB249,46,3
1c. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to
2indicate that he or she is a clinical nurse specialist unless he or she has been granted
3a clinical nurse specialist specialty designation under sub. (1) (c) 1. a.
SB249,46,64 d. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate
5that he or she is a nurse practitioner unless he or she has been granted a nurse
6practitioner specialty designation under sub. (1) (c) 1. a.
SB249,46,97 (c) An advanced practice registered nurse shall adhere to professional
8standards when managing situations that are beyond the advanced practice nurse's
9expertise.
SB249,46,1610 (d) An advanced practice registered nurse licensed under this section may
11delegate a task or order to another clinically trained health care worker if the task
12or order is within the scope of the advanced practice registered nurse's practice, the
13advanced practice registered nurse is competent to perform the task or issue the
14order, and the advanced practice registered nurse has reasonable evidence that the
15health care worker is minimally competent to perform the task or issue the order
16under the circumstances.
SB249,46,21 17(4) Continuing education. Every advanced practice registered nurse shall
18submit to the board evidence of having completed at least 16 contact hours per
19biennium in clinical pharmacology or therapeutics relevant to the advanced practice
20registered nurse's area of practice. The board may promulgate rules regarding the
21continuing education requirements under this subsection.
SB249,47,5 22(5) Malpractice liability insurance. Except for a person whose employer has
23in effect malpractice liability insurance that provides coverage for the person in the
24amounts specified under s. 655.23 (4), no person may practice advanced practice
25registered nursing unless he or she at all times has in effect malpractice liability

1insurance coverage in the minimum amounts required by the rules of the board. An
2advanced practice registered nurse shall submit evidence of that coverage to the
3board when applying for an initial license under this section or a renewal of a license
4under this section. An advanced practice registered nurse shall also submit such
5evidence to the board upon request of the board.
SB249,47,7 6(6) Rules. The board shall promulgate rules necessary to administer this
7section, including rules for all of the following:
SB249,47,118 (a) Further defining the scope of practice of an advanced practice registered
9nurse, defining the scope of practice for each recognized role, and defining the scope
10of practice within which an advanced practice registered nurse who holds a permit
11issued under sub. (2) may issue prescription orders.
SB249,47,1312 (b) Determining acceptable national certification for purposes of sub. (1) (a) 2.
13a.
SB249,47,1714 (c) Establishing the appropriate education, training, or experience
15requirements that a registered nurse must satisfy to be an advanced practice
16registered nurse and to qualify to be granted a permit to issue prescription orders
17under sub. (2).
SB249,47,2018 (d) Specifying the classes of drugs, individual drugs, or devices that may not
19be prescribed by an advanced practice registered nurse who holds a permit to issue
20prescription orders under sub. (2).
SB249,47,2121 (e) Specifying the conditions to be met for registered nurses to do the following:
SB249,47,2222 1. Administer a drug prescribed by an advanced practice registered nurse.
SB249,47,2323 2. Administer a drug at the direction of an advanced practice registered nurse.
SB249,48,224 (f) Establishing the minimum amount of malpractice liability insurance
25coverage that an advanced practice registered nurse must at all times have in effect

1for purposes of sub. (5). The board shall promulgate rules under this paragraph in
2consultation with the commissioner of insurance.
SB249,93 3Section 93 . 441.10 (7) of the statutes is amended to read:
SB249,48,164 441.10 (7) No license is required for practical nursing, but, except as provided
5in s. 257.03, no person without a license may hold himself or herself out as a licensed
6practical nurse or licensed attendant, use the title or letters “Trained Practical
7Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “ Licensed Attendant" or
8“L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is
9a licensed practical nurse or licensed attendant. No licensed practical nurse or
10licensed attendant may use the title, or otherwise seek to act as a registered, licensed,
11graduate or professional nurse. Anyone violating this subsection shall be subject to
12the penalties prescribed by s. 441.13. The board shall grant without examination a
13license as a licensed practical nurse to any person who was on July 1, 1949, a licensed
14attendant.
This subsection does not apply to any licensed practical nurse who holds
15a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than
16this state, that has adopted the enhanced nurse licensure compact under s. 441.51.
SB249,94 17Section 94. 441.11 (title) of the statutes is repealed.
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