AB50,1343,12 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:

AB50,1343,15 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.

AB50,1343,17 b. On January 1, 2026, the person did not hold a certificate under s. 441.16 (2), 2023 stats.

AB50,1344,8 (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.

AB50,1344,12 (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.

AB50,1344,16 (b) An advanced practice registered nurse may not issue prescription orders if a notation under sub. (1) (b) 5. indicating that the advanced practice registered nurse may not issue prescription orders appears on the advanced practice registered nurse’s license.

AB50,1344,20 (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.

AB50,1345,2 2. Notwithstanding s. 441.14, 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.

AB50,1345,7 (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.

AB50,1345,8 2. Except as provided in s. 257.03, no person may do any of the following:

AB50,1345,11 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.

AB50,1345,15 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.

AB50,1345,18 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.

AB50,1345,21 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.

AB50,1346,2 (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.

AB50,1346,4 2. Subdivision 1. does not apply to an advanced practice registered nurse with a certified nurse-midwife specialty designation.

AB50,1346,10 (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:

AB50,1346,17 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.

AB50,1346,20 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.

AB50,1347,6 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.

AB50,1347,9 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.

AB50,1347,13 (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].

AB50,1347,19 (d) 1. Except as otherwise provided in this paragraph, an advanced practice registered nurse may provide chronic pain management services only while working in a collaborative relationship with a physician who, through education, training, and experience, specializes in pain management. This subdivision applies regardless of whether the advanced practice registered nurse has qualified for independent practice under par. (b).

AB50,1347,23 2. Except as provided in par. (f), subd. 1. does not apply to an advanced practice registered nurse who is providing chronic 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).

AB50,1348,4 3. Except as provided in par. (f), subd. 1. does not apply to an advanced practice registered nurse who has qualified for independent practice under par. (b) and has privileges in a hospital, as defined in s. 50.33 (2), to provide chronic pain management services without a collaborative relationship with a physician.

AB50,1348,10 (e) For purposes of pars. (a) 1. and (d) 1. and 3., 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.

AB50,1348,16 (em) Any advanced practice registered nurse who may provide chronic pain management services without a collaborative relationship with a physician as provided in par. (d) 3. shall inform the hospital in which the advanced practice registered nurse has privileges as described under par. (d) 3. that the advanced practice registered nurse may provide chronic pain management services without a collaborative relationship with a physician.

AB50,1348,20 (f) Nothing in this section prohibits an entity employing or with a relationship with an advanced practice registered nurse from establishing additional requirements for an advanced practice registered nurse as a condition of employment or relationship.

AB50,1349,2 (g) An advanced practice registered nurse shall adhere to professional standards when managing situations that are beyond the advanced practice registered nurse’s expertise. If a particular patient’s needs are beyond the advanced practice registered nurse’s expertise, the advanced practice registered nurse shall, as warranted by the patient’s needs, consult or collaborate with or refer the patient to at least one of the following: