AB396,48,2
14. The applicant provides evidence of any malpractice liability insurance
2coverage required under sub. (5).
AB396,48,63
5. If the applicant is applying to receive a certified nurse-midwife specialty
4designation under par. (b) 1., the applicant provides evidence satisfactory to the
5board that the applicant is currently certified by the American Midwifery
6Certification Board or its successor.
AB396,48,87
6. The applicant does not have an arrest or conviction record, subject to ss.
8111.321, 111.322, and 111.335.
AB396,48,119
7. The applicant meets any other criteria established by the board by rule under
10sub. (6) (c) relating to the education, training, or experience required for each
11recognized role.
AB396,48,1712
(b) 1. a. Subject to subd. 3. and s. 441.07 (1g), the board shall grant an advanced
13practice registered nurse license to an applicant the board determines meets the
14requirements under par. (a). The board shall also grant a person who is granted a
15license under this subd. 1. a. one or more specialty designations corresponding to the
16recognized roles for which the board determines that the person qualifies based on
17the person's qualifications under par. (a).
AB396,48,2318
b. The board shall grant an advanced practice registered nurse license to each
19individual who, on the day before the effective date of this subd. 1. b. .... [LRB inserts
20date], was certified to issue prescription orders under s. 441.16, 2019 stats. The
21board shall also grant a person who is granted a license under this subd. 1. b. one or
22more specialty designations corresponding to the recognized roles for which the
23board determines that the person qualifies based on the person's qualifications.
AB396,49,324
c. The board shall grant an advanced practice registered nurse license to each
25individual who, on the day before the effective date of this subd. 1. c. .... [LRB inserts
1date], was licensed as a nurse-midwife under s. 441.15, 2019 stats. The board shall
2also grant a person who is granted a license under this subd. 1. c. a nurse-midwife
3specialty designation.
AB396,49,54
2. Each specialty designation granted under subd. 1. shall appear on the
5person's advanced practice registered nurse license.
AB396,49,86
3. The board may not grant an advanced practice registered nurse license to
7a person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless
8the board also grants the person the license under s. 441.06 (1), (1c), or (1m).
AB396,49,109
4. The board may place specific limitations on a person licensed as an advanced
10practice registered nurse as a condition of licensure.
AB396,49,1311
5. If all of the following apply to a person, a notation indicating that the person
12may not issue prescription orders shall appear on the person's advanced practice
13registered nurse license:
AB396,49,1614
a. The person is granted an advanced practice registered nurse license under
15subd. 1. a. and satisfies only par. (a) 2. b. but not par. (a) 2. a., or the person is granted
16an advanced practice registered nurse license under subd. 1. c.
AB396,49,1817
b. On January 1, 2019, the person did not hold a certificate under s. 441.16 (2),
182019 Stats.
AB396,50,619
(c) On or before the applicable renewal date specified under s. 440.08 (2) (a),
20an advanced practice registered nurse shall submit to the board on a form furnished
21by the board a statement giving his or her name and residence, the nursing workforce
22survey and fee required under s. 441.01 (7), evidence of having satisfied the
23continuing education requirements under sub. (4), evidence of any malpractice
24liability insurance coverage required under sub. (5), current evidence that the person
25satisfies each of the requirements under par. (a) 1., 2., 5., and 7. that apply with
1respect to the person, and any other information that the board requires by rule, with
2the applicable renewal fee determined by the department under s. 440.03 (9) (a). The
3board shall grant to a person who satisfies the requirements under this paragraph
4the renewal of his or her advanced practice registered nurse license and specialty
5designations granted under par. (b) 1. and shall, if the person holds a license under
6s. 441.06 (1), (1c), or (1m), also grant the renewal of that license.
AB396,50,10
7(2) Prescribing authority. (a) Except as provided in par. (b), an advanced
8practice registered nurse may issue prescription orders, subject to the rules
9promulgated under sub. (6) (a) and (d), and may provide expedited partner therapy
10in the manner described in s. 441.092.
AB396,50,1411
(b) An advanced practice registered nurse may not issue prescription orders if
12a notation under sub. (1) (b) 5. indicating that the advanced practice registered nurse
13may not issue prescription orders appears on the advanced practice registered
14nurse's license.
AB396,50,17
15(3) Practice; titles. (a) 1. The holder of a license issued under this section is
16an “advanced practice registered nurse," may append to his or her name the title
17“A.P.R.N.," and is authorized to practice advanced practice registered nursing.
AB396,50,2018
2. The holder of a specialty designation for a recognized role granted under sub.
19(1) (b) 1. may append to his or her name the title and an abbreviation corresponding
20to that recognized role.
AB396,50,2521
(b) 1. Except as provided in par. (d) and s. 257.03, no person may practice or
22attempt to practice advanced practice registered nursing, nor use the title “advanced
23practice registered nurse," the title “A.P.R.N.," or anything else to indicate that he
24or she is an advanced practice registered nurse unless he or she is licensed under this
25section.
AB396,51,1
12. Except as provided in s. 257.03, no person may do any of the following:
AB396,51,42
a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else
3to indicate that he or she is a certified nurse-midwife unless he or she has been
4granted a certified nurse-midwife specialty designation under sub. (1) (b) 1.
AB396,51,85
b. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or
6anything else to indicate that he or she is a certified registered nurse anesthetist
7unless he or she has been granted a certified registered nurse anesthetist specialty
8designation under sub. (1) (b) 1.
AB396,51,119
c. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to
10indicate that he or she is a clinical nurse specialist unless he or she has been granted
11a clinical nurse specialist specialty designation under sub. (1) (b) 1.
AB396,51,1412
d. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate
13that he or she is a nurse practitioner unless he or she has been granted a nurse
14practitioner specialty designation under sub. (1) (b) 1.
AB396,51,2015
(c) An advanced practice registered nurse shall adhere to professional
16standards when managing situations that are beyond the advanced practice
17registered nurse's expertise. If a particular patient's needs are beyond the advanced
18practice registered nurse's expertise, the advanced practice registered nurse shall
19consult or collaborate with another health care provider or refer the patient to
20another health care provider, as warranted by the patient's needs.
AB396,52,221
(d) An advanced practice registered nurse licensed under this section may
22delegate a task or order to another clinically trained health care worker if the task
23or order is within the scope of the advanced practice registered nurse's practice, the
24advanced practice registered nurse is competent to perform the task or issue the
25order, and the advanced practice registered nurse has reasonable evidence that the
1health care worker is minimally competent to perform the task or issue the order
2under the circumstances.
AB396,52,83
(e) If an advanced practice registered nurse with a certified nurse-midwife
4specialty designation under sub. (1) (b) 1. practices outside of a hospital setting, the
5advanced practice registered nurse shall file and keep current with the department
6a proactive plan for involving a hospital or a physician who has admitting privileges
7at a hospital in the treatment of patients with higher acuity or emergency care needs
8that exceed the advanced practice registered nurse's scope of practice.
AB396,52,129
(f) Nothing in this section prohibits an employer, hospital, or other entity with
10a relationship with an advanced practice registered nurse from establishing
11employment practice requirements on the advanced practice registered nurse as a
12condition of employment.
AB396,52,17
13(4) Continuing education. Every advanced practice registered nurse shall
14submit to the board evidence of having completed at least 16 contact hours per
15biennium in clinical pharmacology or therapeutics relevant to the advanced practice
16registered nurse's area of practice. The board may promulgate rules regarding the
17continuing education requirements under this subsection.
AB396,53,2
18(5) Malpractice liability insurance. Except for a person whose employer has
19in effect malpractice liability insurance that provides coverage for the person in the
20amounts specified under s. 655.23 (4), no person may practice advanced practice
21registered nursing unless he or she at all times has in effect malpractice liability
22insurance coverage in the minimum amounts required by the rules of the board. An
23advanced practice registered nurse shall submit evidence of that coverage to the
24board when applying for an initial license under this section or a renewal of a license
1under this section. An advanced practice registered nurse shall also submit such
2evidence to the board upon request of the board.
AB396,53,8
3(5m) Nurse anesthetists. (b)
Opt-out of federal certified registered nurse
4anesthetist supervision requirement. 1. The legislature finds that allowing certified
5registered nurse anesthetists to administer anesthesia without supervision or
6direction from an operating practitioner, physician, or anesthesiologist increases
7access to quality anesthesia services throughout the state and is in the best interests
8of the citizens of the state.
AB396,53,119
2. The state, including the governor, the board, and the medical examining
10board, shall act to maintain an opt-out of the federal requirement for physician
11supervision of certified registered nurse anesthetists pursuant to
42 CFR 482.52 (c).
AB396,53,13
12(6) Rules. The board shall promulgate rules necessary to administer this
13section, including rules for all of the following:
AB396,53,1814
(a) Further defining the scope of practice of an advanced practice registered
15nurse, practice of a certified nurse-midwife, practice of a certified registered nurse
16anesthetist, practice of a nurse practitioner, and practice of a clinical nurse specialist
17and defining the scope of practice within which an advanced practice registered
18nurse may issue prescription orders under sub. (2).
AB396,53,2019
(b) Determining acceptable national certification for purposes of sub. (1) (a) 2.
20a.
AB396,53,2321
(c) Establishing the appropriate education, training, or experience
22requirements that a registered nurse must satisfy in order to be an advanced practice
23registered nurse.
AB396,53,2524
(d) Specifying the classes of drugs, individual drugs, or devices that may not
25be prescribed by an advanced practice registered nurse under sub. (2).
AB396,54,1
1(e) Specifying the conditions to be met for registered nurses to do the following:
AB396,54,22
1. Administer a drug prescribed by an advanced practice registered nurse.
AB396,54,33
2. Administer a drug at the direction of an advanced practice registered nurse.
AB396,54,74
(f) Establishing the minimum amount of malpractice liability insurance
5coverage that an advanced practice registered nurse must at all times have in effect
6for purposes of sub. (5). The board shall promulgate rules under this paragraph in
7consultation with the commissioner of insurance.
AB396,109
8Section
109. 441.092 of the statutes is created to read:
AB396,54,9
9441.092 Expedited partner therapy.
(1) In this section:
AB396,54,1010
(b) “Antimicrobial drug" has the meaning given in s. 448.035 (1) (b).
AB396,54,1111
(c) “Expedited partner therapy" has the meaning given in s. 448.035 (1) (c).
AB396,54,23
12(2) Notwithstanding the requirements of s. 448.9785, an advanced practice
13registered nurse who may issue prescription orders under s. 441.09 (2) may provide
14expedited partner therapy if a patient is diagnosed as infected with a chlamydial
15infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with
16a sexual partner during which the chlamydial infection, gonorrhea, or
17trichomoniasis may have been transmitted to or from the sexual partner. The
18advanced practice registered nurse shall attempt to obtain the name of the patient's
19sexual partner. A prescription order for an antimicrobial drug prepared under this
20subsection shall include the name and address of the patient's sexual partner, if
21known. If the advanced practice registered nurse is unable to obtain the name of the
22patient's sexual partner, the prescription order shall include, in ordinary, bold-faced
23capital letters, the words, “expedited partner therapy" or the letters “EPT."
AB396,55,2
24(3) The advanced practice registered nurse shall provide the patient with a
25copy of the information sheet prepared by the department of health services under
1s. 46.03 (44) and shall request that the patient give the information sheet to the
2person with whom the patient had sexual contact.
AB396,55,7
3(4) (a) Except as provided in par. (b), an advanced practice registered nurse is
4immune from civil liability for injury to or the death of a person who takes any
5antimicrobial drug if the antimicrobial drug is prescribed, dispensed, or furnished
6under this section and if expedited partner therapy is provided as specified under
7this section.
AB396,55,118
(b) The immunity under par. (a) does not extend to the donation, distribution,
9furnishing, or dispensing of an antimicrobial drug by an advanced practice
10registered nurse whose act or omission involves reckless, wanton, or intentional
11misconduct.
AB396,110
12Section 110
. 441.10 (7) of the statutes is amended to read:
AB396,55,2513
441.10
(7) No license is required for practical nursing, but, except as provided
14in s. 257.03, no person without a license may hold himself or herself out as a licensed
15practical nurse or licensed attendant, use the title or letters “Trained Practical
16Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “
Licensed Attendant" or
17“L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is
18a licensed practical nurse or licensed attendant. No licensed practical nurse or
19licensed attendant may use the title, or otherwise seek to act as a registered, licensed,
20graduate or professional nurse. Anyone violating this subsection shall be subject to
21the penalties prescribed by s. 441.13.
The board shall grant without examination a
22license as a licensed practical nurse to any person who was on July 1, 1949, a licensed
23attendant. This subsection does not apply to any licensed practical nurse who holds
24a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than
25this state, that has adopted the
enhanced nurse licensure compact
under s. 441.51.
AB396,111
1Section
111. 441.11 (title) of the statutes is repealed.
AB396,112
2Section 112
. 441.11 (1) of the statutes is repealed.
AB396,113
3Section
113. 441.11 (2) of the statutes is renumbered 441.09 (5m) (a) and
4amended to read:
AB396,56,105
441.09
(5m) (a)
Licensure exemption. The provisions of s.
448.04 (1) (g) 448.03
6(1) (d) do not apply to
a an advanced practice registered nurse licensed under this
7section who possesses a certified registered nurse anesthetist
specialty designation
8under sub. (1) (b) 1. or
to a person who engages in the practice of a nurse anesthetist
9while performing official duties for the armed services or federal health services of
10the United States.
AB396,114
11Section
114. 441.11 (3) of the statutes is repealed.
AB396,115
12Section
115. 441.15 of the statutes is repealed.
AB396,116
13Section 116
. 441.16 of the statutes is repealed.
AB396,117
14Section 117
. 441.18 (2) (a) (intro.) of the statutes is amended to read:
AB396,56,1615
441.18
(2) (a) (intro.) An advanced practice
registered nurse
certified to who
16may issue prescription orders under s.
441.16
441.09 (2) may do any of the following:
AB396,118
17Section 118
. 441.18 (2) (b) of the statutes is amended to read:
AB396,56,2418
441.18
(2) (b) An advanced practice
registered nurse who prescribes or delivers
19an opioid antagonist under par. (a) 1. shall ensure that the person to whom the opioid
20antagonist is prescribed has or has the capacity to provide the knowledge and
21training necessary to safely administer the opioid antagonist to an individual
22undergoing an opioid-related overdose and that the person demonstrates the
23capacity to ensure that any individual to whom the person further delivers the opioid
24antagonist has or receives that knowledge and training.
AB396,119
25Section 119
. 441.18 (3) of the statutes is amended to read:
AB396,57,6
1441.18
(3) An advanced practice
registered nurse who, acting in good faith,
2prescribes or delivers an opioid antagonist in accordance with sub. (2), or who, acting
3in good faith, otherwise lawfully prescribes or dispenses an opioid antagonist, shall
4be immune from criminal or civil liability and may not be subject to professional
5discipline under s. 441.07 for any outcomes resulting from prescribing, delivering,
6or dispensing the opioid antagonist.
AB396,120
7Section 120
. 441.19 of the statutes is repealed.
AB396,121
8Section 121
. Subchapter II (title) of chapter 441 [precedes 441.51] of the
9statutes is amended to read:
AB396,57,1010
Chapter 441
AB396,57,1111
SUBCHAPTER II
AB396,57,12
12ENHANCED NURSE LICENSURE COMPACT
AB396,122
13Section 122
. 441.51 (title) of the statutes is amended to read:
AB396,57,14
14441.51 (title)
Enhanced nurse Nurse licensure compact.
AB396,123
15Section 123
. 448.03 (2) (a) of the statutes is amended to read:
AB396,57,2216
448.03
(2) (a) Any person lawfully practicing within the scope of a license,
17permit, registration, certificate or certification granted to practice midwifery under
18subch. XIII of ch. 440, to practice professional
or
, practical
, or advanced practice
19registered nursing
or nurse-midwifery under ch. 441, to practice chiropractic under
20ch. 446, to practice dentistry or dental hygiene under ch. 447, to practice optometry
21under ch. 449, to practice acupuncture under ch. 451 or under any other statutory
22provision, or as otherwise provided by statute.
AB396,58,7
1448.03
(2) (a) Any person lawfully practicing within the scope of a license,
2permit, registration, certificate or certification granted to practice midwifery under
3subch. XIII of ch. 440, to practice professional, practical, or advanced practice
4registered nursing under ch. 441, to practice chiropractic under ch. 446, to practice
5dentistry or dental hygiene under ch. 447, to practice optometry under ch. 449, to
6practice as a physician assistant under subch. VIII, to practice acupuncture under
7ch. 451 or under any other statutory provision, or as otherwise provided by statute.
AB396,125
8Section
125. 448.035 (1) (a) of the statutes is repealed.
AB396,126
9Section 126
. 448.035 (2), (3) and (4) of the statutes are amended to read:
AB396,58,2310
448.035
(2) Notwithstanding the requirements of s. 448.30, a physician
, or a 11physician assistant
, or certified advanced practice nurse prescriber may provide
12expedited partner therapy if the patient is diagnosed as infected with a chlamydial
13infection, gonorrhea, or trichomoniasis and the patient has had sexual contact with
14a sexual partner during which the chlamydial infection, gonorrhea, or
15trichomoniasis may have been transmitted to or from the sexual partner. The
16physician
, or physician assistant
, or certified advanced practice nurse prescriber 17shall attempt to obtain the name of the patient's sexual partner. A prescription order
18for an antimicrobial drug prepared under this subsection shall include the name and
19address of the patient's sexual partner, if known. If the physician
, or physician
20assistant
, or certified advanced practice nurse prescriber is unable to obtain the
21name of the patient's sexual partner, the prescription order shall include, in ordinary
22bold-faced capital letters, the words, “expedited partner therapy" or the letters
23“EPT."
AB396,59,3
24(3) The physician
, or physician assistant
, or certified advanced practice nurse
25prescriber shall provide the patient with a copy of the information sheet prepared by
1the department of health services under s. 46.03 (44) and shall request that the
2patient give the information sheet to the person with whom the patient had sexual
3contact.
AB396,59,8
4(4) (a) Except as provided in par. (b), a physician
, or physician assistant
, or
5certified advanced practice nurse prescriber is immune from civil liability for injury
6to or the death of a person who takes any antimicrobial drug if the antimicrobial drug
7is prescribed, dispensed, or furnished under this section and if expedited partner
8therapy is provided as specified under this section.
AB396,59,129
(b) The immunity under par. (a) does not extend to the donation, distribution,
10furnishing, or dispensing of an antimicrobial drug by a physician
, or physician
11assistant
, or certified advanced practice nurse prescriber whose act or omission
12involves reckless, wanton, or intentional misconduct.
AB396,59,2515
448.035
(2) Notwithstanding the requirements of s. 448.30, a physician may
16provide expedited partner therapy if the patient is diagnosed as infected with a
17chlamydial infection, gonorrhea, or trichomoniasis and the patient has had sexual
18contact with a sexual partner during which the chlamydial infection, gonorrhea, or
19trichomoniasis may have been transmitted to or from the sexual partner. The
20physician shall attempt to obtain the name of the patient's sexual partner. A
21prescription order for an antimicrobial drug prepared under this subsection shall
22include the name and address of the patient's sexual partner, if known. If the
23physician is unable to obtain the name of the patient's sexual partner, the
24prescription order shall include, in ordinary bold-faced capital letters, the words,
25“expedited partner therapy" or the letters “EPT."
AB396,60,4
1(3) The physician shall provide the patient with a copy of the information sheet
2prepared by the department of health services under s. 46.03 (44) and shall request
3that the patient give the information sheet to the person with whom the patient had
4sexual contact.
AB396,60,8
5(4) (a) Except as provided in par. (b), a physician is immune from civil liability
6for injury to or the death of a person who takes any antimicrobial drug if the
7antimicrobial drug is prescribed, dispensed, or furnished under this section and if
8expedited partner therapy is provided as specified under this section.
AB396,60,119
(b) The immunity under par. (a) does not extend to the donation, distribution,
10furnishing, or dispensing of an antimicrobial drug by a physician whose act or
11omission involves reckless, wanton, or intentional misconduct.
AB396,128
12Section 128
. 448.56 (1) and (1m) (b) of the statutes are amended to read:
AB396,61,213
448.56
(1) Written referral. Except as provided in this subsection and s.
14448.52, a person may practice physical therapy only upon the written referral of a
15physician, physician assistant, chiropractor, dentist, podiatrist, or advanced practice
16registered nurse
prescriber certified under s. 441.16 (2). Written referral is not
17required if a physical therapist provides services in schools to children with
18disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the
19department of public instruction; provides services as part of a home health care
20agency; provides services to a patient in a nursing home pursuant to the patient's
21plan of care; provides services related to athletic activities, conditioning, or injury
22prevention; or provides services to an individual for a previously diagnosed medical
23condition after informing the individual's physician, physician assistant,
24chiropractor, dentist, podiatrist, or advanced practice
registered nurse
prescriber
25certified under s. 441.16 (2) who made the diagnosis. The examining board may
1promulgate rules establishing additional services that are excepted from the written
2referral requirements of this subsection.
AB396,61,8
3(1m) (b) The examining board shall promulgate rules establishing the
4requirements that a physical therapist must satisfy if a physician, physician
5assistant, chiropractor, dentist, podiatrist, or advanced practice
registered nurse
6prescriber makes a written referral under sub. (1). The purpose of the rules shall be
7to ensure continuity of care between the physical therapist and the health care
8practitioner.