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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:
SB249,53,521 448.67 (2) Separate billing required. Except as provided in sub. (4), a licensee
22who renders any podiatric service or assistance, or gives any podiatric advice or any
23similar advice or assistance, to any patient, podiatrist, physician, physician
24assistant, advanced practice registered nurse prescriber certified under s. 441.16 (2),
25partnership, or corporation, or to any other institution or organization, including a

1hospital, for which a charge is made to a patient, shall, except as authorized by
2Title 18 or Title 19 of the federal Social Security Act, render an individual statement
3or account of the charge directly to the patient, distinct and separate from any
4statement or account by any other podiatrist, physician, physician assistant,
5advanced practice registered nurse prescriber, or other person.
SB249,112 6Section 112 . 448.956 (1m) of the statutes is amended to read:
SB249,53,127 448.956 (1m) Subject to sub. (1) (a), a licensee may provide athletic training
8to an individual without a referral, except that a licensee may not provide athletic
9training as described under s. 448.95 (5) (d) or (e) in an outpatient rehabilitation
10setting unless the licensee has obtained a written referral for the individual from a
11practitioner licensed or certified under subch. II, III, IV, V, or VII of this chapter;
12under ch. 446; or under s. 441.16 (2) 441.09.
SB249,113 13Section 113. 450.01 (1m) of the statutes is repealed.
SB249,114 14Section 114 . 450.01 (16) (h) 2. of the statutes is amended to read:
SB249,53,1815 450.01 (16) (h) 2. The patient's advanced practice registered nurse prescriber,
16if the advanced practice registered nurse prescriber has entered into a written
17agreement to collaborate with a physician
holds a permit to issue prescription orders
18under s. 441.09 (2)
.
SB249,115 19Section 115 . 450.01 (16) (hr) 2. of the statutes is amended to read:
SB249,53,2120 450.01 (16) (hr) 2. An advanced practice registered nurse prescriber who holds
21a permit to issue prescription orders under s. 441.09 (2)
.
SB249,116 22Section 116 . 450.03 (1) (e) of the statutes is amended to read:
SB249,54,423 450.03 (1) (e) Any person lawfully practicing within the scope of a license,
24permit, registration, certificate, or certification granted to provide home medical
25oxygen under s. 450.076, to practice professional or , practical, or advanced practice

1registered
nursing or nurse-midwifery under ch. 441, to practice dentistry or dental
2hygiene under ch. 447, to practice medicine and surgery under ch. 448, to practice
3optometry under ch. 449 or to practice veterinary medicine under ch. 89, or as
4otherwise provided by statute.
SB249,117 5Section 117 . 450.11 (1i) (a) 1. of the statutes is amended to read:
SB249,54,166 450.11 (1i) (a) 1. A pharmacist may, upon and in accordance with the
7prescription order of an advanced practice registered nurse prescriber under s.
8441.18 (2) (a) 1., or of a physician or physician assistant under s. 448.037 (2) (a) 1.,
9that complies with the requirements of sub. (1), deliver an opioid antagonist to a
10person specified in the prescription order and may, upon and in accordance with the
11standing order of an advanced practice registered nurse prescriber under s. 441.18
12(2) (a) 2., or of a physician or physician assistant under s. 448.037 (2) (a) 2., that
13complies with the requirements of sub. (1), deliver an opioid antagonist to an
14individual in accordance with the order. The pharmacist shall provide a consultation
15in accordance with rules promulgated by the board for the delivery of a prescription
16to the person to whom the opioid antagonist is delivered.
SB249,118 17Section 118 . 450.11 (1i) (b) 2. b. of the statutes is amended to read:
SB249,54,2018 450.11 (1i) (b) 2. b. An advanced practice registered nurse prescriber may only
19deliver or dispense an opioid antagonist in accordance with s. 441.18 (2) or in
20accordance with his or her other legal authority to dispense prescription drugs.
SB249,119 21Section 119 . 450.11 (7) (b) of the statutes is amended to read:
SB249,54,2522 450.11 (7) (b) Information communicated to a physician, physician assistant,
23or advanced practice registered nurse prescriber in an effort to procure unlawfully
24a prescription drug or the administration of a prescription drug is not a privileged
25communication.
SB249,120
1Section 120. 450.11 (8) (e) of the statutes is amended to read:
SB249,55,32 450.11 (8) (e) The board of nursing, insofar as this section applies to advanced
3practice nurse prescribers registered nurses.
SB249,121 4Section 121 . 450.13 (5) (b) of the statutes is amended to read:
SB249,55,85 450.13 (5) (b) The patient's advanced practice registered nurse prescriber, if the
6advanced practice registered nurse prescriber has entered into a written agreement
7to collaborate with a physician
holds a permit to issue prescription orders under s.
8441.09 (2)
.
SB249,122 9Section 122 . 450.135 (7) (b) of the statutes is amended to read:
SB249,55,1310 450.135 (7) (b) The patient's advanced practice registered nurse prescriber, if
11the advanced practice registered nurse prescriber has entered into a written
12agreement to collaborate with a physician
holds a permit to issue prescription orders
13under s. 441.09 (2)
.
SB249,123 14Section 123 . 462.04 of the statutes is amended to read:
SB249,55,22 15462.04 Prescription or order required. A person who holds a license or
16limited X-ray machine operator permit under this chapter may not use diagnostic
17X-ray equipment on humans for diagnostic purposes unless authorized to do so by
18prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
19under s. 447.04 (1), a podiatrist licensed under s. 448.63, a chiropractor licensed
20under s. 446.02, an advanced practice registered nurse certified licensed under s.
21441.16 (2) 441.09, a physician assistant licensed under s. 448.04 (1) (f), or, subject to
22s. 448.56 (7) (a), a physical therapist licensed under s. 448.53.
SB249,124 23Section 124. 655.001 (7t) of the statutes is amended to read:
SB249,56,324 655.001 (7t) “Health care practitioner" means a health care professional, as
25defined in s. 180.1901 (1m), who is an employee of a health care provider described

1in s. 655.002 (1) (d), (e), (em), or (f) and who has the authority to provide health care
2services that are not in collaboration with a physician under s. 441.15 (2) (b) or under
3the direction and supervision of a physician or nurse anesthetist.
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