SB394: Bill Text

SB394,38,17 343.16 (5) (a) The secretary may require any applicant for a license or any licensed operator to submit to a special examination by such persons or agencies as the secretary may direct to determine incompetency, physical or mental disability, disease, or any other condition that might prevent such applicant or licensed person from exercising reasonable and ordinary control over a motor vehicle. If the department requires the applicant to submit to an examination, the applicant shall pay for the examination. If the department receives an application for a renewal or duplicate license after voluntary surrender under s. 343.265 or receives a report from a physician, physician assistant, advanced practice registered nurse licensed under s. 441.09, or optometrist under s. 146.82 (3), or if the department has a report of 2 or more arrests within a one-year period for any combination of violations of s. 346.63 (1) or (5) or a local ordinance in conformity with s. 346.63 (1) or (5) or a law of a federally recognized American Indian tribe or band in this state in conformity with s. 346.63 (1) or (5), or s. 346.63 (1m), 1985 stats., or s. 346.63 (2) or (6) or 940.25, or s. 940.09 where the offense involved the use of a vehicle, the department shall determine, by interview or otherwise, whether the operator should submit to an examination under this section. The examination may consist of an assessment. If the examination indicates that education or treatment for a disability, disease or condition concerning the use of alcohol, a controlled substance or a controlled substance analog is appropriate, the department may order a driver safety plan in accordance with s. 343.30 (1q). If there is noncompliance with assessment or the driver safety plan, the department shall revoke the person's operating privilege in the manner specified in s. 343.30 (1q) (d).

SB394,77 Section 77 . 343.51 (1) of the statutes is amended to read:

SB394,39,15 343.51 (1) Any person who qualifies for registration plates of a special design under s. 341.14 (1), (1a), (1m), or (1q) or any other person with a disability that limits or impairs the ability to walk may request from the department a special identification card that will entitle any motor vehicle parked by, or under the direction of, the person, or a motor vehicle operated by or on behalf of the organization when used to transport such a person, to parking privileges under s. 346.50 (2), (2a), and (3). The department shall issue the card at a fee to be determined by the department, upon submission by the applicant, if the applicant is an individual rather than an organization, of a statement from a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a public health nurse certified or licensed to practice in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state and listed in the Christian Science journal that the person is a person with a disability that limits or impairs the ability to walk. The statement shall state whether the disability is permanent or temporary and, if temporary, the opinion of the physician, advanced practice registered nurse, public health nurse, physician assistant, podiatrist, chiropractor, or practitioner as to the duration of the disability. The department shall issue the card upon application by an organization on a form prescribed by the department if the department believes that the organization meets the requirements under this subsection.

SB394,78 Section 78 . 343.62 (4) (a) 4. of the statutes is amended to read:

SB394,39,25 343.62 (4) (a) 4. The applicant submits with the application a statement completed within the immediately preceding 24 months, except as provided by rule, by a physician licensed to practice medicine in any state, from an advanced practice registered nurse licensed to practice nursing in any state, from a physician assistant licensed or certified to practice in any state, from a podiatrist licensed to practice in any state, from a chiropractor licensed to practice chiropractic in any state, or from a Christian Science practitioner residing in this state, and listed in the Christian Science journal certifying that, in the medical care provider's judgment, the applicant is physically fit to teach driving.

SB394,79 Section 79. 440.03 (13) (b) 3. of the statutes is repealed.

SB394,80 Section 80. 440.03 (13) (b) 39m. of the statutes is created to read:

SB394,40,3 440.03 (13) (b) 39m. Nurse, advanced practice registered.

SB394,81 Section 81. 440.03 (13) (b) 42. of the statutes is repealed.

SB394,82 Section 82. 440.08 (2) (a) 4m. of the statutes is repealed.

SB394,83 Section 83. 440.08 (2) (a) 47. of the statutes is created to read:

SB394,40,8 440.08 (2) (a) 47. Nurse, advanced practice registered: March 1 of each even-numbered year.

SB394,84 Section 84. 440.08 (2) (a) 50. of the statutes is repealed.

SB394,85 Section 85 . 440.094 (1) (c) 1. of the statutes, as created by 2021 Wisconsin Act 10, is amended to read:

SB394,40,14 440.094 (1) (c) 1. A registered nurse, licensed practical nurse, or nurse midwife licensed under ch. 441, or an advanced practice registered nurse prescriber certified licensed under ch. 441.

SB394,86 Section 86 . 440.094 (2) (a) (intro.) of the statutes, as created by 2021 Wisconsin Act 10, is amended to read:

SB394,40,23 440.094 (2) (a) (intro.) Notwithstanding ss. 441.06 (4), 441.15 (2), 441.16, 441.09 (3) (b), 446.02 (1), 447.03 (1) and (2), 448.03 (1) (a), (b), and (c) and (1m), 448.51 (1), 448.61, 448.76, 448.961 (1) and (2), 449.02 (1), 450.03 (1), 451.04 (1), 455.02 (1m), 457.04 (4), (5), (6), and (7), 459.02 (1), 459.24 (1), and 460.02, a health care provider may provide services within the scope of the credential that the health care provider holds and the department shall grant the health care provider a temporary credential to practice under this section if all of the following apply:

SB394,87 Section 87 . 440.981 (1) of the statutes is amended to read:

SB394,41,5 440.981 (1) No person may use the title “licensed midwife," describe or imply that he or she is a licensed midwife, or represent himself or herself as a licensed midwife unless the person is granted a license under this subchapter or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09.

SB394,88 Section 88 . 440.982 (1) of the statutes is amended to read:

SB394,41,11 440.982 (1) No person may engage in the practice of midwifery unless the person is granted a license under this subchapter, is granted a temporary permit pursuant to a rule promulgated under s. 440.984 (2m), or is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09.

SB394,89 Section 89 . 440.987 (2) of the statutes is amended to read:

SB394,41,16 440.987 (2) One member who is licensed as a nurse-midwife under s. 441.15 an advanced practice registered nurse and possesses a certified nurse-midwife specialty designation under s. 441.09 and who practices in an out-of-hospital setting.

SB394,90 Section 90 . 441.001 (1c) of the statutes is created to read:

SB394,41,23 441.001 (1c) Advanced practice registered nursing. “Advanced practice registered nursing” means the advanced practice of nursing in one of the 4 recognized roles based on advanced clinical knowledge and skills focusing on direct care of individuals, greater responsibility, autonomy, and accountability for the provision of care, health promotion and maintenance, including prescribing pharmacological agents and therapeutics, and management of patient conditions.

SB394,91 Section 91 . 441.001 (1m) of the statutes is created to read:

SB394,42,8 441.001 (1m) Clinical pharmacology or therapeutics. “Clinical pharmacology or therapeutics” means the identification of individual and classes of drugs, their indications and contraindications, their efficacy, their side effects, and their interactions, as well as clinical judgment skills and decision-making based on thorough interviewing, history taking, physical assessment, test selection and interpretation, pathophysiology, epidemiology, diagnostic reasoning, differentiation of conditions, treatment decisions, case evaluation, and nonpharmacological interventions.

SB394,92 Section 92. 441.001 (3c) of the statutes is created to read:

SB394,42,14 441.001 (3c) Practice of a certified nurse-midwife. “Practice of a certified nurse-midwife” means practice in the management of women's health care, pregnancy, childbirth, postpartum care for newborns, family planning, and gynecological services consistent with the standards of practice of the American College of Nurse-Midwives or its successor.

SB394,93 Section 93. 441.001 (3g) of the statutes is created to read:

SB394,42,22 441.001 (3g) Practice of a certified registered nurse anesthetist. “Practice of a certified registered nurse anesthetist” means providing anesthesia care, pain management care, and care related to anesthesia and pain management for persons across their lifespan, whose health status may range from healthy through all levels of acuity, including persons with immediate, severe, or life-threatening illness or injury, in diverse settings, including hospitals, ambulatory surgery centers, outpatient clinics, medical offices, and home health care settings.

SB394,94 Section 94. 441.001 (3n) of the statutes is created to read:

SB394,43,2 441.001 (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.

SB394,95 Section 95. 441.001 (3r) of the statutes is created to read:

SB394,43,7 441.001 (3r) Practice of a nurse practitioner. “Practice of a nurse practitioner” means practice in ambulatory, acute, and long-term care settings as a primary and specialty care provider who assesses, diagnoses, treats, and manages acute, episodic, and chronic illnesses.

SB394,96 Section 96. 441.001 (3w) of the statutes is created to read:

SB394,43,10 441.001 (3w) Prescription order. “Prescription order” has the meaning given in s. 450.01 (21).

SB394,97 Section 97 . 441.001 (5) of the statutes is created to read:

SB394,43,13 441.001 (5) Recognized role. “Recognized role” means one of the following roles:

SB394,43,14 (a) Certified nurse-midwife.

SB394,43,15 (b) Certified registered nurse anesthetist.

SB394,43,16 (c) Clinical nurse specialist.

SB394,43,17 (d) Nurse practitioner.

SB394,98 Section 98 . 441.01 (3) of the statutes is amended to read:

SB394,43,25 441.01 (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.

SB394,99 Section 99. 441.01 (4) of the statutes is amended to read:

SB394,44,7 441.01 (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.

SB394,100 Section 100 . 441.01 (7) (a) (intro.) of the statutes is amended to read:

SB394,44,12 441.01 (7) (a) (intro.) The board shall require each applicant for the renewal of a registered nurse or, licensed practical nurse, or advanced practice registered nurse license issued under this chapter to do all of the following as a condition for renewing the license:

SB394,101 Section 101 . 441.01 (7) (b) of the statutes is amended to read:

SB394,44,20 441.01 (7) (b) The board may not renew a registered nurse or, licensed practical nurse, or advanced practice registered 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 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.

SB394,102 Section 102 . 441.01 (7) (c) of the statutes is created to read:

SB394,44,24 441.01 (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.

SB394,103 Section 103 . 441.06 (title) of the statutes is repealed and recreated to read:

SB394,45,1 441.06 (title) Registered nurses; civil liability exemption.

SB394,104 Section 104. 441.06 (3) of the statutes is amended to read:

SB394,45,8 441.06 (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 specified 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).

SB394,105 Section 105 . 441.06 (4) of the statutes is amended to read:

SB394,45,18 441.06 (4) Except as provided in s. 257.03, 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 s. 257.03, 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 enhanced nurse licensure compact under s. 441.51.

SB394,106 Section 106. 441.06 (7) of the statutes is renumbered 441.09 (7) and amended to read:

SB394,45,23 441.09 (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:

SB394,46,3 (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.

SB394,46,8 (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.

SB394,107 Section 107. 441.07 (1g) (intro.), (a), (c) and (e) of the statutes are amended to read:

SB394,46,18 441.07 (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:

SB394,46,19 (a) Fraud in the procuring or renewal of the certificate or license.

SB394,46,22 (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.

SB394,46,25 (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).

SB394,108 Section 108. 441.09 of the statutes is created to read:

SB394,47,5 441.09 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:

SB394,47,6 1. The applicant satisfies one of the following criteria:

SB394,47,8 a. The applicant holds a valid license to practice as a registered nurse issued under s. 441.06 (1), (1c), or (1m).

SB394,47,10 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.

SB394,47,13 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.

SB394,47,15 2. The applicant provides evidence satisfactory to the board that he or she satisfies one of the following criteria:

SB394,47,20 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.

SB394,47,24 b. On January 1, 2019, 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) (c) relating to practice, education, or certification.

SB394,47,25 3. The applicant pays the fee specified under s. 440.05 (1).

SB394,48,2 4. The applicant provides evidence of any malpractice liability insurance coverage required under sub. (5).

SB394,48,6 5. If the applicant is applying to receive a certified nurse-midwife specialty designation under par. (b) 1., the applicant provides evidence satisfactory to the board that the applicant is currently certified by the American Midwifery Certification Board or its successor.

SB394,48,8 6. The applicant does not have an arrest or conviction record, subject to ss. 111.321, 111.322, and 111.335.

SB394,48,11 7. The applicant meets any other criteria established by the board by rule under sub. (6) (c) relating to the education, training, or experience required for each recognized role.

SB394,48,17 (b) 1. a. Subject to subd. 3. and 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).

SB394,48,23 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, 2019 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.

SB394,49,3 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, 2019 stats. The board shall also grant a person who is granted a license under this subd. 1. c. a nurse-midwife specialty designation.

SB394,49,5 2. Each specialty designation granted under subd. 1. shall appear on the person's advanced practice registered nurse license.

SB394,49,8 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).

SB394,49,10 4. The board may place specific limitations on a person licensed as an advanced practice registered nurse as a condition of licensure.

SB394,49,13 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: