LRB-2286/2
PG&MDK:wlj:jf
1999 - 2000 LEGISLATURE
April 22, 1999 - Introduced by Representatives Johnsrud, Wasserman, Albers,
Ainsworth, Bock, Brandemuehl, Carpenter, Cullen, Hahn, Gunderson,
Grothman, Hutchison, Seratti, Huebsch, Ladwig, Turner, Stone, Petrowski,
Klusman, Musser, Underheim, Jensen, J. Lehman, Olsen, Townsend, Pettis,
Walker, La Fave, Miller and Huber, cosponsored by Senators Robson, Rude,
Schultz, Darling, Clausing, Lazich, Moore, Cowles, Huelsman, Panzer and
Rosenzweig, by request of Wisconsin State Board of Nursing. Referred to
Committee on Health.
AB305,1,6
1An Act to amend 441.01 (1), 441.06 (1), 441.06 (4), 441.07 (1) (b), 441.10 (3) (a),
2441.10 (3) (c), 441.11 (1) to (3), 441.11 (4), 441.115 (1), 441.115 (2) (a), 441.115
3(2) (b), 441.13 and 441.15 (3) (a);
to repeal and recreate 441.11 (3) and 441.11
4(4); and
to create subchapter I (title) of chapter 441 [precedes 441.01] and
5subchapter II of chapter 441 [precedes 441.50] of the statutes;
relating to:
6adopting the nurse licensure compact and granting rule-making authority.
Analysis by the Legislative Reference Bureau
Under current law, no person may practice professional nursing in this state
unless he or she is licensed as a registered nurse by the board of nursing. Although
a license is not required for practical nursing, no person without such a license issued
by the board of nursing may hold himself or herself out as a licensed practiced nurse
or indicate in any way that he or she is a licensed practical nurse. Exceptions to these
prohibitions are provided for temporary practice. In addition, current law provides
a mechanism for persons who are licensed in other states to be issued a license in this
state without retaking the national licensing examination.
This bill adopts the interstate compact on nurse licensure, which was approved
by the national council of state boards of nursing on December 15, 1997. Under the
compact, a nurse who is licensed in a party state (a state that has adopted the
compact) may practice nursing in any other party state without obtaining a license
in the other state. The compact requires every nurse practicing in a party state to
comply with the practice laws of that state and allows each party state to limit or
revoke the multistate licensure privilege.
The compact also requires each party state to participate in the establishment
of a coordinated data base of all licensed nurses. The system includes information
on the licensure and disciplinary history of each nurse.
For further information see the state and local fiscal estimate, which will be
printed as an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB305, s. 1
1Section
1. Subchapter I (title) of chapter 441 [precedes 441.01] of the statutes
2is created to read:
AB305,2,54
subchapter i
5
Regulation of nursing
AB305, s. 2
6Section
2. 441.01 (1) of the statutes is amended to read:
AB305,2,77
441.01
(1) In this
chapter subchapter, "board" means board of nursing.
AB305, s. 3
8Section
3. 441.06 (1) of the statutes is amended to read:
AB305,3,29
441.06
(1) An applicant for licensure as a registered nurse who complies with
10the requirements of this
chapter subchapter and satisfactorily passes an
11examination shall receive a license. The holder of such a license of another state or
12territory or province of Canada may be granted a license without examination if the
13holder's credentials of general and professional educational qualifications and other
14qualifications are comparable to those required in this state during the same period
15and if the board is satisfied from the holder's employment and professional record
16that the holder is currently competent to practice the profession. The board shall
17evaluate the credentials and determine the equivalency and competency in each
1case. The application for licensure without examination shall be accompanied by the
2fee prescribed in s. 440.05 (2).
AB305, s. 4
3Section
4. 441.06 (4) of the statutes is amended to read:
AB305,3,114
441.06
(4) No person may practice or attempt to practice professional nursing,
5nor use the title, letters, or anything else to indicate that he or she is a registered or
6professional nurse unless he or she is licensed under this section. No person not so
7licensed may use in connection with his or her nursing employment or vocation any
8title or anything else to indicate that he or she is a trained, certified or graduate
9nurse.
This subsection does not apply to any person who is licensed to practice
10nursing by a jurisdiction, other than this state, that has adopted the nurse licensure
11compact under s. 441.50.
AB305, s. 5
12Section
5. 441.07 (1) (b) of the statutes is amended to read:
AB305,3,1413
441.07
(1) (b) One or more violations of this
chapter subchapter or any rule
14adopted by the board under the authority of this
chapter subchapter.
AB305, s. 6
15Section
6. 441.10 (3) (a) of the statutes is amended to read:
AB305,3,2116
441.10
(3) (a) On complying with this
chapter subchapter relating to applicants
17for licensure as licensed practical nurses, and passing an examination, the applicant
18shall receive a license as a licensed practical nurse. The holder of the license is a
19"licensed practical nurse" and may append the letters "L.P.N." to his or her name.
20The board may reprimand or may limit, suspend or revoke the license of a licensed
21practical nurse under s. 441.07.
AB305, s. 7
22Section
7. 441.10 (3) (c) of the statutes is amended to read:
AB305,4,1023
441.10
(3) (c) No license is required for practical nursing, but no person without
24a license may hold himself or herself out as a licensed practical nurse or licensed
25attendant, use the title or letters "Trained Practical Nurse" or "T.P.N.", "Licensed
1Practical Nurse" or "L.P.N.", "Licensed Attendant" or "L.A.", "Trained Attendant" or
2"T.A.", or otherwise seek to indicate that he or she is a licensed practical nurse or
3licensed attendant. No licensed practical nurse or licensed attendant may use the
4title, or otherwise seek to act as a registered, licensed, graduate or professional
5nurse. Anyone violating this subsection shall be subject to the penalties prescribed
6by s. 441.13. The board shall grant without examination a license as a licensed
7practical nurse to any person who was on July 1, 1949, a licensed attendant.
This
8paragraph does not apply to any person who is licensed to practice practical nursing
9by a jurisdiction, other than this state, that has adopted the nurse licensure compact
10under s. 441.50.
AB305, s. 8
11Section
8. 441.11 (1) to (3) of the statutes are amended to read:
AB305,4,1412
441.11
(1) For compensation. Wherever the term "compensation" is used in
13this
chapter subchapter it shall include indirect compensation as well as direct
14compensation and also the expectation thereof whether actually received or not.
AB305,4,19
15(2) Nurse and nursing. Except as provided under s. 441.08, wherever the term
16"nurse" is used in this
chapter subchapter without modification or amplification it
17shall mean only a registered nurse. Wherever the term "nursing" is used in this
18chapter subchapter without modification or amplification it shall mean the practice
19of professional nursing as specified in sub. (4).
AB305,5,8
20(3) Practice of practical nursing. The practice of practical nursing under this
21chapter subchapter means the performance for compensation of any simple acts in
22the care of convalescent, subacutely or chronically ill, injured or infirm persons, or
23of any act or procedure in the care of the more acutely ill, injured or infirm under the
24specific direction of a nurse, physician, podiatrist licensed under ch. 448, dentist
25licensed under ch. 447 or optometrist licensed under ch. 449, or under an order of a
1person who is licensed to practice medicine, podiatry or dentistry in another state if
2that person prepared the order after examining the patient in that other state and
3directs that the order be carried out in this state. A simple act is one
which that does
4not require any substantial nursing skill, knowledge or training, or the application
5of nursing principles based on biological, physical or social sciences, or the
6understanding of cause and effect in such acts and is one
which that is of a nature
7of those approved by the board for the curriculum of schools for licensed practical
8nurses.
AB305,5,2411
441.11
(3) Practice of practical nursing. The practice of practical nursing
12under this subchapter means the performance for compensation of any simple acts
13in the care of convalescent, subacutely or chronically ill, injured or infirm persons,
14or of any act or procedure in the care of the more acutely ill, injured or infirm under
15the specific direction of a nurse, physician, podiatrist licensed under ch. 448, dentist
16licensed under ch. 447 or optometrist licensed under ch. 449, or under an order of a
17person who is licensed to practice medicine, podiatry, dentistry or optometry in
18another state if that person prepared the order after examining the patient in that
19other state and directs that the order be carried out in this state. A simple act is one
20that does not require any substantial nursing skill, knowledge or training, or the
21application of nursing principles based on biological, physical or social sciences, or
22the understanding of cause and effect in such acts and is one that is of a nature of
23those approved by the board for the curriculum of schools for licensed practical
24nurses.
AB305, s. 10
25Section
10. 441.11 (4) of the statutes is amended to read:
AB305,6,16
1441.11
(4) Practice of professional nursing. The practice of professional
2nursing within the terms of this
chapter subchapter means the performance for
3compensation of any act in the observation or care of the ill, injured or infirm, or for
4the maintenance of health or prevention of illness of others, which act requires
5substantial nursing skill, knowledge or training, or application of nursing principles
6based on biological, physical and social sciences, such as the observation and
7recording of symptoms and reactions, the execution of procedures and techniques in
8the treatment of the sick under the general or special supervision or direction of a
9physician, podiatrist licensed under ch. 448, dentist licensed under ch. 447 or
10optometrist licensed under ch. 449, or under an order of a person who is licensed to
11practice medicine, podiatry or dentistry in another state if that person prepared the
12order after examining the patient in that other state and directs that the order be
13carried out in this state, and the execution of general nursing procedures and
14techniques. Except as provided in s. 50.04 (2) (b), the practice of professional nursing
15includes the supervision of a patient and the supervision and direction of licensed
16practical nurses and less skilled assistants.
AB305,7,919
441.11
(4) Practice of professional nursing. The practice of professional
20nursing within the terms of this subchapter means the performance for
21compensation of any act in the observation or care of the ill, injured or infirm, or for
22the maintenance of health or prevention of illness of others, which act requires
23substantial nursing skill, knowledge or training, or application of nursing principles
24based on biological, physical and social sciences, such as the observation and
25recording of symptoms and reactions, the execution of procedures and techniques in
1the treatment of the sick under the general or special supervision or direction of a
2physician, podiatrist licensed under ch. 448, dentist licensed under ch. 447 or
3optometrist licensed under ch. 449, or under an order of a person who is licensed to
4practice medicine, podiatry, dentistry or optometry in another state if that person
5prepared the order after examining the patient in that other state and directs that
6the order be carried out in this state, and the execution of general nursing procedures
7and techniques. Except as provided in s. 50.04 (2) (b), the practice of professional
8nursing includes the supervision of a patient and the supervision and direction of
9licensed practical nurses and less skilled assistants.
AB305, s. 12
10Section
12. 441.115 (1) of the statutes is amended to read:
AB305,7,1711
441.115
(1) This chapter shall not be construed to affect nursing by friends,
12members of the family or undergraduates in an accredited school, nor be construed
13to interfere with members of religious communities or orders having charge of
14hospitals or taking care of the sick in their homes, except that none of such excepted
15persons while engaged in such activities shall represent
himself or herself as a
16registered, trained, certified or graduate nurse unless registered under this
chapter 17subchapter.
AB305, s. 13
18Section
13. 441.115 (2) (a) of the statutes is amended to read:
AB305,7,2519
441.115
(2) (a) In this subsection, "nursing credential" means a license, permit
20or certificate of registration or certification that is granted to a person by another
21state or territory or by a foreign country or province and that authorizes or qualifies
22the person holding the credential to perform acts that are substantially the same as
23those performed by a person licensed as a registered nurse or licensed practical nurse
24under this
chapter subchapter. In this paragraph, "state or territory" excludes any
25state or territory that has adopted the nurse licensure compact under s. 441.50.
AB305, s. 14
1Section
14. 441.115 (2) (b) of the statutes is amended to read:
AB305,8,142
441.115
(2) (b) A person who holds a current, valid nursing credential may
3practice professional or practical nursing in this state, as provided under par. (c), for
4not more than 72 consecutive hours each year without holding a license granted by
5the board under this
chapter subchapter if the board determines that the
6requirements for the nursing credential that the person holds are substantially
7equivalent to the requirements for licensure under this
chapter subchapter. Except
8in an emergency, the person shall provide to the board, at least 7 days before
9practicing professional or practical nursing for the person who is specified under par.
10(c) 2., written notice that includes the name of the person providing notice, the type
11of nursing credential that the person holds and the name of the state, territory,
12foreign country or province that granted the nursing credential. In the event of an
13emergency, the person shall provide to the board written notice that includes the
14information otherwise required under this paragraph, as soon as practicable.
AB305, s. 15
15Section
15. 441.13 of the statutes is amended to read:
AB305,8,18
16441.13 Penalty. (1) Any person violating this
chapter subchapter or
17knowingly employing another in violation of this
chapter subchapter may be fined
18not more than $250 or imprisoned not more than one year in the county jail.
AB305,8,22
19(2) No action may be brought or other proceeding had to recover compensation
20for professional nursing services unless at the time such services were rendered the
21person rendering the same was a registered nurse or had a temporary permit issued
22under this
chapter subchapter.
AB305,8,23
23(3) The remedy of injunction may be used in enforcing this
chapter subchapter.
AB305, s. 16
24Section
16. 441.15 (3) (a) of the statutes is amended to read:
AB305,9,5
1441.15
(3) (a) The board shall grant a license to engage in the practice of
2nurse-midwifery to any person licensed as a registered nurse under this
chapter 3subchapter or in a party state, as defined in s. 441.50 (2) (j), who meets the
4educational and training prerequisites established by the board for the practice of
5nurse-midwifery and who pays the fee specified under s. 440.05 (1).
AB305, s. 17
6Section
17. Subchapter II of chapter 441 [precedes 441.50] of the statutes is
7created to read:
AB305,9,98
subchapter II
9
nurse licensure compact
AB305,9,10
10441.50 Nurse Licensure Compact.
AB305,9,11
11(1) Article I - Findings and Declaration of Purpose.
AB305,9,1212
(a) The party states find all of the following:
AB305,9,1513
1. That the health and safety of the public are affected by the degree of
14compliance with and the effectiveness of enforcement activities related to state nurse
15licensure laws.
AB305,9,1716
2. That violations of nurse licensure and other laws regulating the practice of
17nursing may result in injury or harm to the public.
AB305,9,2118
3. That the expanded mobility of nurses and the use of advanced
19communication technologies as part of our nation's health care delivery system
20require greater coordination and cooperation among states in the areas of nurse
21licensure and regulation.
AB305,9,2322
4. That new practice modalities and technology make compliance with
23individual state nurse licensure laws difficult and complex.
AB305,9,2524
5. That the current system of duplicative licensure for nurses practicing in
25multiple states is cumbersome and redundant to both nurses and states.
AB305,10,1
1(b) The general purposes of this compact are as follows:
AB305,10,22
1. To facilitate the states' responsibility to protect the public's health and safety.
AB305,10,43
2. To ensure and encourage the cooperation of party states in the areas of nurse
4licensure and regulation.
AB305,10,65
3. To facilitate the exchange of information between party states in the areas
6of nurse regulation, investigation and adverse actions.
AB305,10,87
4. To promote compliance with the laws governing the practice of nursing in
8each jurisdiction.