Amendment SA1-SSA2-SB70

SB70-SSA2-SA1,801 Section 801. 441.001 (3n) of the statutes is created to read:

SB70-SSA2-SA1,366,7 441.001 (3n) Practice of a clinical nurse specialist. “Practice of a clinical nurse specialist” means providing advanced nursing care, primarily in health care facilities, including the diagnosis and treatment of illness for identified specific populations based on a specialty.

SB70-SSA2-SA1,802 Section 802. 441.001 (3r) of the statutes is created to read:

SB70-SSA2-SA1,366,13 441.001 (3r) Practice of a nurse practitioner. “Practice of a nurse practitioner” means practice in ambulatory, acute, long-term, or other health care settings as a primary or specialty care provider who provides health services, including assessing, diagnosing, treating, or managing acute, episodic, and chronic illnesses.

SB70-SSA2-SA1,803 Section 803. 441.001 (3w) of the statutes is created to read:

SB70-SSA2-SA1,366,16 441.001 (3w) Prescription order. “Prescription order” has the meaning given in s. 450.01 (21).

SB70-SSA2-SA1,804 Section 804. 441.001 (5) of the statutes is created to read:

SB70-SSA2-SA1,366,19 441.001 (5) Recognized role. “Recognized role” means one of the following roles:

SB70-SSA2-SA1,366,20 (a) Certified nurse-midwife.

SB70-SSA2-SA1,366,21 (b) Certified registered nurse anesthetist.

SB70-SSA2-SA1,366,22 (c) Clinical nurse specialist.

SB70-SSA2-SA1,366,23 (d) Nurse practitioner.

SB70-SSA2-SA1,805 Section 805. 441.01 (3) of the statutes is amended to read:

SB70-SSA2-SA1,367,7 441.01 (3) The board may promulgate rules to establish minimum standards for schools for professional nurses and, schools for licensed practical nurses, and schools for advanced practice registered nurses, including all related clinical units and facilities, and make and provide periodic surveys and consultations to such schools. It The board may also establish promulgate rules to prevent unauthorized persons from practicing professional nursing. It shall approve all rules for the administration of this chapter in accordance with ch. 227.

SB70-SSA2-SA1,806 Section 806. 441.01 (4) of the statutes is amended to read:

SB70-SSA2-SA1,367,14 441.01 (4) The board shall direct that those schools that qualify be placed on a list of schools the board has approved for professional nurses or, of schools the board has approved for licensed practical nurses, or of schools the board has approved for advanced practice registered nurses on application and proof of qualifications;, and the board shall make a study of nursing education and initiate promulgate rules and policies to improve it.

SB70-SSA2-SA1,149e Section 149e. 441.01 (7) (a) (intro.) and 1. of the statutes are amended to read:

SB70-SSA2-SA1,367,19 441.01 (7) (a) (intro.) The board shall require each applicant for the renewal Biennially, each holder of a registered nurse or licensed practical nurse license issued under this chapter to shall do all of the following as a condition for renewing the license:

SB70-SSA2-SA1,367,22 1. Complete and submit to the department with the application for renewal of the license a nursing workforce survey developed by the department of workforce development under s. 106.30 (2).

SB70-SSA2-SA1,149f Section 149f. 441.01 (7) (a) (intro.) of the statutes, as affected by 2023 Wisconsin Act .... (this act), is amended to read:

SB70-SSA2-SA1,368,3 441.01 (7) (a) (intro.) Biennially, each holder of a registered nurse or, licensed practical nurse, or licensed advanced practice registered nurse license issued under this chapter shall do all of the following:

SB70-SSA2-SA1,807 Section 807 . 441.01 (7) (b) of the statutes is amended to read:

SB70-SSA2-SA1,368,11 441.01 (7) (b) The board may not renew a registered nurse or licensed practical nurse license under this chapter unless the renewal applicant has completed the nursing workforce survey to the satisfaction of the board. The board shall establish standards to determine whether the nursing workforce survey has been completed. The board shall, by no later than June 30 of each odd-numbered year, submit all completed nursing workforce survey forms to the department of workforce development.

SB70-SSA2-SA1,808 Section 808. 441.01 (7) (c) of the statutes is created to read:

SB70-SSA2-SA1,368,15 441.01 (7) (c) An applicant who is renewing both a registered nurse and advanced practice registered nurse license under s. 441.09 (1) (c) is only required to pay a single fee under par. (a) 2.

SB70-SSA2-SA1,809 Section 809. 441.06 (title) of the statutes is repealed and recreated to read:

SB70-SSA2-SA1,368,17 441.06 (title) Registered nurses; civil liability exemption.

SB70-SSA2-SA1,152e Section 152e. 441.06 (3) of the statutes is amended to read:

SB70-SSA2-SA1,368,24 441.06 (3) A registered nurse practicing for compensation shall, on or before the applicable renewal date specified determined by the department under s. 440.08 (2) (a), submit to the board on furnished forms a statement giving name, residence, and other facts that the board requires, with the nursing workforce survey and fee required under s. 441.01 (7) and the applicable renewal fee determined by the department under s. 440.03 (9) (a).

SB70-SSA2-SA1,152f Section 152f. 441.06 (3) of the statutes, as affected by 2023 Wisconsin Act .... (this act), is amended to read:

SB70-SSA2-SA1,369,8 441.06 (3) A Except as provided in s. 441.09 (1) (c), a registered nurse practicing for compensation shall, on or before the applicable renewal date determined by the department under s. 440.08 (2), submit to the board on furnished forms a statement giving name, residence, and other facts that the board requires, with the applicable renewal fee determined by the department under s. 440.03 (9) (a).

SB70-SSA2-SA1,810 Section 810. 441.06 (4) of the statutes is amended to read:

SB70-SSA2-SA1,369,18 441.06 (4) Except as provided in ss. 257.03 and 440.077, no person may practice or attempt to practice professional nursing, nor use the title, letters, or anything else to indicate that he or she is a registered or professional nurse unless he or she is licensed under this section. Except as provided in ss. 257.03 and 440.077, no person not so licensed may use in connection with his or her nursing employment or vocation any title or anything else to indicate that he or she is a trained, certified or graduate nurse. This subsection does not apply to any registered nurse who holds a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted the nurse licensure compact under s. 441.51.

SB70-SSA2-SA1,811 Section 811. 441.06 (7) of the statutes is renumbered 441.09 (7) and amended to read:

SB70-SSA2-SA1,369,23 441.09 (7) Civil liability. No person certified licensed as an advanced practice registered nurse prescriber under s. 441.16 (2) this section is liable for civil damages for any of the following:

SB70-SSA2-SA1,370,3 (a) Reporting in good faith to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment impairs the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB70-SSA2-SA1,370,8 (b) In good faith, not reporting to the department of transportation under s. 146.82 (3) a patient's name and other information relevant to a physical or mental condition of the patient that in the advanced practice nurse prescriber's registered nurse's judgment does not impair the patient's ability to exercise reasonable and ordinary control over a motor vehicle.

SB70-SSA2-SA1,812 Section 812. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended to read:

SB70-SSA2-SA1,370,18 441.07 (1g) (intro.) Subject to the rules promulgated under s. 440.03 (1), the board may deny an initial license or revoke, limit, suspend, or deny the renewal of a license of a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse; deny an initial certificate or revoke, limit, suspend, or deny the renewal of a certificate to prescribe drugs or devices granted under s. 441.16; or reprimand a registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse, if the board finds that the applicant or licensee committed any of the following:

SB70-SSA2-SA1,370,19 (a) Fraud in the procuring or renewal of the certificate or license.

SB70-SSA2-SA1,370,22 (c) Acts which that show the registered nurse, nurse-midwife advanced practice registered nurse, or licensed practical nurse to be unfit or incompetent by reason of negligence, abuse of alcohol or other drugs, or mental incompetency.

SB70-SSA2-SA1,370,25 (e) A violation of any state or federal law that regulates prescribing or dispensing drugs or devices, if the person has a certificate to prescribe drugs or devices under s. 441.16 may issue prescription orders under s. 441.09 (2).

SB70-SSA2-SA1,813 Section 813. 441.09 of the statutes is created to read:

SB70-SSA2-SA1,371,5 441.09 Advanced practice registered nurses; civil liability exemption. (1) License. (a) An applicant who satisfies all of the following requirements may apply to the board for initial licensure by the board as an advanced practice registered nurse:

SB70-SSA2-SA1,371,6 1. The applicant satisfies one of the following criteria:

SB70-SSA2-SA1,371,8 a. The applicant holds a valid license to practice as a registered nurse issued under s. 441.06 (1), (1c), or (1m).

SB70-SSA2-SA1,371,10 b. The applicant applies concurrently for a license under s. 441.06 (1), (1c), or (1m) with the application for a license under this paragraph.

SB70-SSA2-SA1,371,13 c. The applicant is a registered nurse who holds a multistate license, as defined in s. 441.51 (2) (h), issued by a jurisdiction, other than this state, that has adopted the nurse licensure compact.

SB70-SSA2-SA1,371,15 2. The applicant provides evidence satisfactory to the board that he or she satisfies one of the following criteria:

SB70-SSA2-SA1,371,20 a. The applicant has completed a graduate-level or postgraduate-level education program that is approved by the board and that prepares the applicant for the practice of advanced practice registered nursing in one of the 4 recognized roles, and the applicant holds a current certification by a national certifying body approved by the board.

SB70-SSA2-SA1,371,24 b. On January 1, 2023, the applicant was licensed as a registered nurse in this state and was practicing in a recognized role, and the applicant satisfies additional criteria established by the board by rule under sub. (6) (a) 3. relating to practice, education, or certification.

SB70-SSA2-SA1,371,25 3. The applicant pays the fee specified under s. 440.05 (1).

SB70-SSA2-SA1,372,2 4. The applicant provides to the board evidence of any malpractice liability insurance coverage required under sub. (5).

SB70-SSA2-SA1,372,4 5. If the applicant is applying to receive a certified nurse-midwife specialty designation under par. (b) 1., the applicant does all of the following:

SB70-SSA2-SA1,372,6 a. Provides evidence satisfactory to the board that the applicant is currently certified by the American Midwifery Certification Board or its successor.

SB70-SSA2-SA1,372,7 b. Files with the board any plan required under sub. (3m) (i).

SB70-SSA2-SA1,372,9 6. The applicant does not have an arrest or conviction record, subject to ss. 111.321, 111.322, and 111.335.

SB70-SSA2-SA1,372,12 7. The applicant meets any other criteria established by the board by rule under sub. (6) (a) 3. relating to the education, training, or experience required for each recognized role.

SB70-SSA2-SA1,372,18 (b) 1. a. Subject to s. 441.07 (1g), the board shall grant an advanced practice registered nurse license to an applicant the board determines meets the requirements under par. (a). The board shall also grant a person who is granted a license under this subd. 1. a. one or more specialty designations corresponding to the recognized roles for which the board determines that the person qualifies based on the person's qualifications under par. (a).

SB70-SSA2-SA1,372,24 b. The board shall grant an advanced practice registered nurse license to each individual who, on the day before the effective date of this subd. 1. b. .... [LRB inserts date], was certified to issue prescription orders under s. 441.16, 2021 stats. The board shall also grant a person who is granted a license under this subd. 1. b. one or more specialty designations corresponding to the recognized roles for which the board determines that the person qualifies based on the person's qualifications.

SB70-SSA2-SA1,373,5 c. The board shall grant an advanced practice registered nurse license to each individual who, on the day before the effective date of this subd. 1. c. .... [LRB inserts date], was licensed as a nurse-midwife under s. 441.15, 2021 stats. The board shall also grant a person who is granted a license under this subd. 1. c. a nurse-midwife specialty designation.

SB70-SSA2-SA1,373,7 2. Each specialty designation granted under subd. 1. shall appear on the person's advanced practice registered nurse license.

SB70-SSA2-SA1,373,10 3. The board may not grant an advanced practice registered nurse license to a person applying concurrently for a license under s. 441.06 (1), (1c), or (1m), unless the board also grants the person the license under s. 441.06 (1), (1c), or (1m).

SB70-SSA2-SA1,373,12 4. The board may place specific limitations on a person licensed as an advanced practice registered nurse as a condition of licensure.

SB70-SSA2-SA1,373,15 5. If all of the following apply to a person, a notation indicating that the person may not issue prescription orders shall appear on the person's advanced practice registered nurse license:

SB70-SSA2-SA1,373,18 a. The person is granted an advanced practice registered nurse license under subd. 1. a. and satisfies only par. (a) 2. b. but not par. (a) 2. a., or the person is granted an advanced practice registered nurse license under subd. 1. c.

SB70-SSA2-SA1,373,20 b. On January 1, 2023, the person did not hold a certificate under s. 441.16 (2), 2021 stats.

SB70-SSA2-SA1,374,9 (c) On or before the applicable renewal date determined by the department under s. 440.08 (2), an advanced practice registered nurse shall submit to the board on a form furnished by the board a statement giving his or her name and residence, the nursing workforce survey and fee required under s. 441.01 (7), evidence of having satisfied the continuing education requirements under sub. (4), evidence of any malpractice liability insurance coverage required under sub. (5), any plan required under sub. (3m) (i), current evidence that the person satisfies each of the requirements under par. (a) 1., 2., 5. a., and 7. that apply with respect to the person, and any other information that the board requires by rule, with the applicable renewal fee determined by the department under s. 440.03 (9) (a). The board shall grant to a person who satisfies the requirements under this paragraph the renewal of his or her advanced practice registered nurse license and specialty designations granted under par. (b) 1. and shall, if the person holds a license under s. 441.06 (1), (1c), or (1m), also grant the renewal of that license.

SB70-SSA2-SA1,374,13 (2) Prescribing authority. (a) Except as provided in par. (b), an advanced practice registered nurse may issue prescription orders, subject to the rules promulgated under sub. (6) (a) 1. and 4., and may provide expedited partner therapy in the manner described in s. 441.092.

SB70-SSA2-SA1,374,17 (b) An advanced practice registered nurse may not issue prescription orders if a notation under sub. (1) (b) 4. indicating that the advanced practice registered nurse may not issue prescription orders appears on the advanced practice registered nurse's license.

SB70-SSA2-SA1,374,21 (3) License required; use of titles. (a) 1. The holder of a license issued under this section is an “advanced practice registered nurse," may append to his or her name the title “A.P.R.N.," and is authorized to practice advanced practice registered nursing.

SB70-SSA2-SA1,374,24 2. Notwithstanding s. 448.03 (3m), the holder of a specialty designation for a recognized role granted under sub. (1) (b) 1. may append to his or her name the title and an abbreviation described under par. (b) 2. corresponding to that recognized role.

SB70-SSA2-SA1,375,5 (b) 1. Except as provided in sub. (3m) (h) and s. 257.03, no person may practice or attempt to practice advanced practice registered nursing, nor use the title “advanced practice registered nurse," the title “A.P.R.N.," or anything else to indicate that he or she is an advanced practice registered nurse unless he or she is licensed under this section.

SB70-SSA2-SA1,375,6 2. Except as provided in s. 257.03, no person may do any of the following:

SB70-SSA2-SA1,375,9 a. Use the title “certified nurse-midwife,” the title “C.N.M.,” or anything else to indicate that he or she is a certified nurse-midwife unless he or she has been granted a certified nurse-midwife specialty designation under sub. (1) (b) 1.

SB70-SSA2-SA1,375,13 b. Use the title “certified registered nurse anesthetist,” the title “C.R.N.A.,” or anything else to indicate that he or she is a certified registered nurse anesthetist unless he or she has been granted a certified registered nurse anesthetist specialty designation under sub. (1) (b) 1.

SB70-SSA2-SA1,375,16 c. Use the title “clinical nurse specialist,” the title “C.N.S.,” or anything else to indicate that he or she is a clinical nurse specialist unless he or she has been granted a clinical nurse specialist specialty designation under sub. (1) (b) 1.

SB70-SSA2-SA1,375,19 d. Use the title “nurse practitioner,” the title “N.P.,” or anything else to indicate that he or she is a nurse practitioner unless he or she has been granted a nurse practitioner specialty designation under sub. (1) (b) 1.

SB70-SSA2-SA1,375,23 (3m) Practice requirements and limitations. (a) 1. An advanced practice registered nurse licensed under this section may, except as provided in subd. 2. and par. (b), practice advanced practice registered nursing only in collaboration with a physician or dentist.

SB70-SSA2-SA1,375,25 2. Subdivision 1. does not apply to an advanced practice registered nurse with a certified nurse-midwife specialty designation.

SB70-SSA2-SA1,376,6 (b) An advanced practice registered nurse to whom par. (a) 1. applies may, except as provided in pars. (d) 1. and (f), practice advanced practice registered nursing in a recognized role without being supervised by or collaborating with, and independent of, a physician or dentist if the board verifies, upon application of the advanced practice registered nurse, that the advanced practice registered nurse satisfies all of the following:

SB70-SSA2-SA1,376,13 1. The advanced practice registered nurse has, except as provided in subd. 3., completed 3,840 hours of professional nursing in a clinical setting. Clinical hours completed as a requirement of a nursing program offered by a qualifying school of nursing described under s. 441.06 (1) (c) may be used to satisfy the requirement under this subdivision. Hours completed to satisfy a requirement of an education program described in sub. (1) (a) 2. a. may not be used to satisfy the requirement under this subdivision.

SB70-SSA2-SA1,376,16 2. At least 24 months have elapsed since the advanced practice registered nurse first began completing the clinical hours required by a nursing program described under subd. 1.

SB70-SSA2-SA1,376,25 3. The advanced practice registered nurse has completed 3,840 clinical hours of advanced practice registered nursing practice in that recognized role while working with a physician or dentist who was immediately available for consultation and accepted responsibility for the actions of the advanced practice registered nurse during those 3,840 hours of practice. The advanced practice registered nurse may substitute additional hours of advanced practice registered nursing working with a physician or dentist described in this subdivision to count toward the requirement under subd. 1. Each such additional hour shall count toward one hour of the requirement under subd. 1.

SB70-SSA2-SA1,377,3 4. At least 24 months have elapsed since the advanced practice registered nurse first began practicing advanced practice registered nursing in that recognized role as described in subd. 3.

SB70-SSA2-SA1,377,7 (c) For purposes of par. (b) 3., hours of advanced practice registered nursing practice may include the lawful practice of advanced practice registered nursing outside this state or the lawful practice of advanced practice registered nursing in this state prior to the effective date of this paragraph .... [LRB inserts date].

SB70-SSA2-SA1,377,13 (d) 1. An advanced practice registered nurse may provide pain management services only while working in a collaborative relationship with a physician who, through education, training, and experience, specializes in pain management. Except as provided in subd. 2., this subdivision applies regardless of whether the advanced practice registered nurse has qualified for independent practice under par. (b).

SB70-SSA2-SA1,377,17 2. Except as provided in par. (f), subd. 1. does not apply to an advanced practice registered nurse who is providing pain management services in a hospital, as defined in s. 50.33 (2), or a clinic associated with a hospital, and who has qualified for independent practice under par. (b).

SB70-SSA2-SA1,377,23 (e) For purposes of pars. (a) 1. and (d) 1., a collaborative relationship is a process in which an advanced practice registered nurse is working with a physician or dentist, in each other's presence when necessary, to deliver health care services within the scope of the advanced practice registered nurse's training, education, and experience. The advanced practice registered nurse shall document such a collaborative relationship.