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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.
SB249,95 18Section 95 . 441.11 (1) of the statutes is repealed.
SB249,96 19Section 96. 441.11 (2) of the statutes is renumbered 441.09 (5m) and amended
20to read:
SB249,48,2321 441.09 (5m) Nurse anesthetists. The provisions of s. 448.04 (1) (g) do not apply
22to a an advanced practice registered nurse licensed under this section who possesses
23a certified registered
nurse anesthetist specialty designation under sub. (1) (c) 1. a.
SB249,97 24Section 97. 441.11 (3) of the statutes is repealed.
SB249,98 25Section 98. 441.15 of the statutes is repealed.
SB249,99
1Section 99. 441.16 of the statutes is repealed.
SB249,100 2Section 100 . 441.18 (2) (a) (intro.) of the statutes is amended to read:
SB249,49,53 441.18 (2) (a) (intro.) An advanced practice registered nurse certified who holds
4a permit
to issue prescription orders under s. 441.16 441.09 (2) may do any of the
5following:
SB249,101 6Section 101 . 441.18 (2) (b) of the statutes is amended to read:
SB249,49,137 441.18 (2) (b) An advanced practice registered nurse who prescribes or delivers
8an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid
9antagonist is prescribed has or has the capacity to provide the knowledge and
10training necessary to safely administer the opioid antagonist to an individual
11undergoing an opioid-related overdose and that the person demonstrates the
12capacity to ensure that any individual to whom the person further delivers the opioid
13antagonist has or receives that knowledge and training.
SB249,102 14Section 102 . 441.18 (3) of the statutes is amended to read:
SB249,49,2015 441.18 (3) An advanced practice registered nurse who, acting in good faith,
16prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting
17in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall
18be immune from criminal or civil liability and may not be subject to professional
19discipline under s. 441.07 for any outcomes resulting from prescribing, delivering,
20or dispensing the opioid antagonist.
SB249,103 21Section 103 . 441.19 of the statutes is repealed.
SB249,104 22Section 104 . Subchapter II (title) of chapter 441 [precedes 441.51] of the
23statutes is amended to read:
SB249,49,2424 Chapter 441
SB249,49,2525 SUBCHAPTER II
SB249,50,1
1ENHANCED NURSE LICENSURE COMPACT
SB249,105 2Section 105 . 441.51 (title) of the statutes is amended to read:
SB249,50,3 3441.51 (title) Enhanced nurse Nurse licensure compact.
SB249,106 4Section 106 . 448.03 (2) (a) of the statutes is amended to read:
SB249,50,115 448.03 (2) (a) Any person lawfully practicing within the scope of a license,
6permit, registration, certificate or certification granted to practice midwifery under
7subch. XIII of ch. 440, to practice professional or , practical, or advanced practice
8registered
nursing or nurse-midwifery under ch. 441, to practice chiropractic under
9ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice optometry
10under ch. 449, to practice acupuncture under ch. 451 or under any other statutory
11provision, or as otherwise provided by statute.
SB249,107 12Section 107. 448.035 (1) (a) of the statutes is repealed.
SB249,108 13Section 108 . 448.035 (2), (3) and (4) of the statutes are amended to read:
SB249,51,314 448.035 (2) Notwithstanding the requirements of s. 448.30, a physician, a
15physician assistant, or certified an advanced practice registered nurse prescriber
16who holds a permit to issue prescription orders under s. 441.09 (2) may provide
17expedited partner therapy if the patient is diagnosed as infected with a chlamydial
18infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with
19a sexual partner during which the chlamydial infection, gonorrhea, or
20trichomoniasis may have been transmitted to or from the sexual partner. The
21physician, physician assistant, or certified advanced practice registered nurse
22prescriber shall attempt to obtain the name of the patient's sexual partner. A
23prescription order for an antimicrobial drug prepared under this subsection shall
24include the name and address of the patient's sexual partner, if known. If the
25physician, physician assistant, or certified advanced practice registered nurse

1prescriber is unable to obtain the name of the patient's sexual partner, the
2prescription order shall include, in ordinary bold-faced capital letters, the words,
3“expedited partner therapy" or the letters “EPT."
SB249,51,8 4(3) The physician, physician assistant, or certified advanced practice
5registered nurse prescriber shall provide the patient with a copy of the information
6sheet prepared by the department of health services under s. 46.03 (44) and shall
7request that the patient give the information sheet to the person with whom the
8patient had sexual contact.
SB249,51,13 9(4) (a) Except as provided in par. (b), a physician, physician assistant, or
10certified advanced practice registered nurse prescriber is immune from civil liability
11for injury to or the death of a person who takes any antimicrobial drug if the
12antimicrobial drug is prescribed, dispensed, or furnished under this section and if
13expedited partner therapy is provided as specified under this section.
SB249,51,1714 (b) The immunity under par. (a) does not extend to the donation, distribution,
15furnishing, or dispensing of an antimicrobial drug by a physician, physician
16assistant, or certified advanced practice registered nurse prescriber whose act or
17omission involves reckless, wanton, or intentional misconduct.
SB249,109 18Section 109 . 448.56 (1) and (1m) (b) of the statutes are amended to read:
SB249,52,819 448.56 (1) Written referral. Except as provided in this subsection and s.
20448.52, a person may practice physical therapy only upon the written referral of a
21physician, physician assistant, chiropractor, dentist, podiatrist, or advanced practice
22registered nurse prescriber certified under s. 441.16 (2). Written referral is not
23required if a physical therapist provides services in schools to children with
24disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the
25department of public instruction; provides services as part of a home health care

1agency; provides services to a patient in a nursing home pursuant to the patient's
2plan of care; provides services related to athletic activities, conditioning, or injury
3prevention; or provides services to an individual for a previously diagnosed medical
4condition after informing the individual's physician, physician assistant,
5chiropractor, dentist, podiatrist, or advanced practice registered nurse prescriber
6certified under s. 441.16 (2)
who made the diagnosis. The examining board may
7promulgate rules establishing additional services that are excepted from the written
8referral requirements of this subsection.
SB249,52,14 9(1m) (b) The examining board shall promulgate rules establishing the
10requirements that a physical therapist must satisfy if a physician, physician
11assistant, chiropractor, dentist, podiatrist, or advanced practice registered nurse
12prescriber makes a written referral under sub. (1). The purpose of the rules shall be
13to ensure continuity of care between the physical therapist and the health care
14practitioner.
SB249,110 15Section 110 . 448.62 (2m) of the statutes is amended to read:
SB249,52,1916 448.62 (2m) An advanced practice registered nurse who is certified to issue
17prescription orders under s. 441.16 and
who is providing nonsurgical patient services
18as directed, supervised, and inspected by a podiatrist who has the power to direct,
19decide, and oversee the implementation of the patient services rendered.
SB249,111 20Section 111 . 448.67 (2) of the statutes is amended to read:
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