AB500: Bill Text

MED:emw

2017 - 2018 LEGISLATURE

2017 Assembly BILL 500

September 20, 2017 - Introduced by Representatives VanderMeer, Tranel, Ripp, Allen, Anderson, Ballweg, Berceau, Bernier, Billings, Born, E. Brooks, R. Brooks, Crowley, Doyle, Duchow, Edming, Felzkowski, Gannon, Genrich, Hutton, Jacque, Jagler, Katsma, Kerkman, Kitchens, Kleefisch, Kooyenga, Kremer, Krug, Kuglitsch, Kulp, Loudenbeck, Macco, Mason, Meyers, Milroy, Murphy, Mursau, Nerison, Neylon, Novak, Nygren, Ott, Petersen, Petryk, Pronschinske, Quinn, Riemer, Rodriguez, Rohrkaste, Sargent, Skowronski, Snyder, Spiros, Spreitzer, Stafsholt, Steffen, Steineke, Stuck, Summerfield, Swearingen, Tauchen, Thiesfeldt, Tittl, Tusler, Vorpagel, Wachs, Wichgers, Zimmerman, Shankland, Kolste and Brostoff, cosponsored by Senators Marklein, Cowles, Olsen, Bewley, Carpenter, Darling, Erpenbach, Feyen, Hansen, Harsdorf, Johnson, LeMahieu, Moulton, Nass, Petrowski, Ringhand, Roth, Shilling, Testin, Tiffany, Vinehout, Wanggaard and Wirch. Referred to Committee on Health.

AB500,1,10 An Act to repeal 441.50; to amend 49.498 (1) (L), 50.01 (1w), 50.01 (5r), 115.001 (11), 118.29 (4), 146.40 (1) (c), 146.40 (1) (f), 250.01 (7), 255.06 (1) (d), 440.03 (11m) (c) 1., 440.03 (13) (b) (intro.), 440.14 (5) (b), 440.15, 441.06 (4), 441.10 (7), 441.115 (2) (a), 441.15 (3) (a) (intro.), subchapter II (title) of chapter 441 [precedes 441.50], 655.001 (9), 905.04 (1) (f), 990.01 (19g), 990.01 (23q) and 990.01 (36m); to repeal and recreate 440.03 (13) (b) (intro.) and 440.15; and to create 14.87, 111.335 (1) (e), 441.06 (1c), 441.10 (1c) and 441.51 of the statutes; relating to: ratification of the Enhanced Nurse Licensure Compact, extending the time limit for emergency rule procedures, and providing an exemption from emergency rule procedures.

Analysis by the Legislative Reference Bureau

This bill ratifies and enters Wisconsin into the Enhanced Nurse Licensure Compact (enhanced compact). The enhanced compact replaces the original Nurse Licensure Compact (original compact), which was ratified in Wisconsin in 1999. Under both versions of the compact, a nurse, whether a registered nurse or a licensed practical nurse, who is licensed in a state that has adopted the compact (party state) may practice in any other party state without needing to separately obtain a license in that other party state. Significant provisions of the enhanced compact, as compared to the original compact, include all of the following:

1. Under the enhanced compact, party states grant multistate nursing licenses, with the compact setting out minimum qualifications that an applicant must satisfy in order to be granted a multistate license, including that an applicant submit to a background investigation. Under the enhanced compact, a multistate license is recognized by each party state as authorizing a nurse to practice, under a multistate licensure privilege, in that party state. The enhanced compact also provides that party states may grant single-state licenses, which authorize practice only within the issuing state. The enhanced compact does not affect the requirements established by a party state for the issuance of a single-state license.

Under the original compact, a license issued by a home state to a resident in that state is simply recognized by each other party state as authorizing a multistate licensure privilege to practice in that party state, with the qualifications for obtaining a license to be determined under each party state's laws.

2. The enhanced compact establishes an Interstate Commission of Nurse Licensure Compact Administrators (commission), which consists of the heads of each party state's board that licenses nurses, or their designees. The commission has various powers and duties granted in the compact, including overseeing the administration of the compact, enforcing the compact, adopting bylaws, promulgating binding rules for the compact, and employing an executive director and employees. Under the original compact, the compact is administered by compact administrators, with the administrator for this state designated as the secretary of safety and professional services or his or her designee.

3. The enhanced compact includes various provisions regarding resolutions of disputes between the commission and party states and between party and nonparty states. The enhanced compact requires the commission to attempt to resolve disputes related to the compact that arise among party states and between party and nonparty states, after which such disputes would be handed through arbitration. Under the original compact, disputes are simply to be handled through arbitration.

4. The enhanced compact includes a process for termination of a party state from the compact that has defaulted in the performance of its obligations under the compact. No such provisions are included in the original compact.

Pursuant to the terms of the enhanced compact, the enhanced compact became effective in party states that have already enacted it on July 20, 2017, which was the date the enhanced compact was signed into law by a 26th state. The enhanced compact may be further amended upon enactment of an amendment by all member states.

The enhanced compact provides that all party states to the enhanced compact that also were parties to the original compact are deemed to have withdrawn from the original compact within six months after the effective date of the enhanced compact.

For further information see the state 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:

AB500,1 Section 1 . 14.87 of the statutes is created to read:

AB500,3,6 14.87 Enhanced nurse licensure compact. There is created an interstate commission of nurse licensure compact administrators as specified in s. 441.51. The administrator of the commission representing this state shall be the chairperson of the board of nursing or his or her designee as provided in s. 441.51 (7) (b) 1. The commission has the powers and duties granted and imposed under s. 441.51.

AB500,2 Section 2. 49.498 (1) (L) of the statutes is amended to read:

AB500,3,10 49.498 (1) (L) “Registered professional nurse" means a registered nurse who is licensed under ch. 441 or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k).

AB500,3 Section 3. 50.01 (1w) of the statutes is amended to read:

AB500,3,15 50.01 (1w) “Licensed practical nurse" means a licensed practical nurse who is licensed or has a temporary permit under s. 441.10 or who is licensed as a licensed practical/vocational nurse holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k).

AB500,4 Section 4. 50.01 (5r) of the statutes is amended to read:

AB500,3,20 50.01 (5r) “Registered nurse" means a registered nurse who is licensed under s. 441.06 or permitted under s. 441.08 or who is licensed as a registered nurse holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k).

AB500,5 Section 5. 111.335 (1) (e) of the statutes is created to read:

AB500,4,3 111.335 (1) (e) Notwithstanding s. 111.322, it is not employment discrimination because of conviction record for the board of nursing to refuse to license an individual in accordance with s. 441.51 (3) (c) 7. and 8.

AB500,6 Section 6. 115.001 (11) of the statutes is amended to read:

AB500,4,10 115.001 (11) School nurse. “School nurse" means a registered nurse who is licensed under ch. 441 or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k), who submits evidence satisfactory to the department that he or she has successfully completed a course, determined to be satisfactory to the department, in public health or community health.

AB500,7 Section 7. 118.29 (4) of the statutes is amended to read:

AB500,5,2 118.29 (4) Written policies. Any school board, county children with disabilities education board, cooperative educational service agency or governing body of a private school whose employees or volunteers may be authorized to administer nonprescription drug products or prescription drugs to pupils under this section shall adopt a written policy governing the administration of nonprescription drug products and prescription drugs to pupils. In developing the policy, the school board, board, agency or governing body shall seek the assistance of one or more school nurses who are employees of the school board, board, agency or governing body or are providing services or consultation under s. 121.02 (1) (g). The policy shall include procedures for obtaining and filing in the school or other appropriate facility the written instructions and consent required under sub. (2) (a), for the periodic review of such written instructions by a registered nurse who is licensed under s. 441.06 or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k), for the storing of nonprescription drug products and prescription drugs, and for record keeping, including documenting the administration of each dose, including errors.

AB500,8 Section 8. 146.40 (1) (c) of the statutes is amended to read:

AB500,5,7 146.40 (1) (c) “Licensed practical nurse" means a licensed practical nurse who is licensed or has a temporary permit under s. 441.10 or is licensed as a licensed practical/vocational nurse who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k).

AB500,9 Section 9. 146.40 (1) (f) of the statutes is amended to read:

AB500,5,12 146.40 (1) (f) “Registered nurse" means a registered nurse who has a certificate of registration license under s. 441.06 or a temporary permit under s. 441.08 or who is licensed as a registered nurse holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k).

AB500,10 Section 10. 250.01 (7) of the statutes is amended to read:

AB500,5,17 250.01 (7) “Registered nurse" means a registered nurse who is licensed under s. 441.06 or in a party state, as defined in s. 441.50 (2) (j), or permitted under s. 441.08 or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.51 (2) (k).

AB500,11 Section 11. 255.06 (1) (d) of the statutes is amended to read:

AB500,5,23 255.06 (1) (d) “Nurse practitioner" means a registered nurse who is licensed under ch. 441 or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j), (k), and whose practice of professional nursing under s. 441.001 (4) includes performance of delegated medical services under the supervision of a physician, dentist, or podiatrist.

AB500,12 Section 12. 440.03 (11m) (c) 1. of the statutes is amended to read:

AB500,6,2 440.03 (11m) (c) 1. The coordinated licensure information system under s. 441.50 (7) 441.51 (6).

AB500,13 Section 13. 440.03 (13) (b) (intro.) of the statutes is amended to read:

AB500,6,9 440.03 (13) (b) (intro.) The department may investigate whether an applicant for or holder of any of the following credentials has been charged with or convicted of a crime only pursuant to rules promulgated by the department under this paragraph, including rules that establish the criteria that the department will use to determine whether an investigation under this paragraph is necessary, except as provided in par. (c) and s. ss. 441.51 (5) (a) 5. and 448.980 (5) (b) 3.:

AB500,14 Section 14 . 440.03 (13) (b) (intro.) of the statutes, as affected by 2015 Wisconsin Act 116, section 5m, and 2017 Wisconsin Act .... (this act), is repealed and recreated to read:

AB500,6,18 440.03 (13) (b) (intro.) The department may investigate whether an applicant for or holder of any of the following credentials has been charged with or convicted of a crime only pursuant to rules promulgated by the department under this paragraph, including rules that establish the criteria that the department will use to determine whether an investigation under this paragraph is necessary, except as provided in par. (c) and s. 441.51 (5) (a) 5.:

AB500,15 Section 15. 440.14 (5) (b) of the statutes is amended to read:

AB500,7,3 440.14 (5) (b) Paragraph (a) does not apply to a list that the department or a credentialing board furnishes to another state agency, a law enforcement agency or a federal governmental agency. In addition, par. (a) does not apply to a list that the department or the board of nursing furnishes to the coordinated licensure information system under s. 441.50 (7) 441.51 (6). A state agency that receives a list from the department or a credentialing board containing a personal identifier of any individual who has made a declaration under sub. (2), (3) or (4) may not disclose the personal identifier to any person other than a state agency, a law enforcement agency or a federal governmental agency.

AB500,16 Section 16. 440.15 of the statutes is amended to read:

AB500,7,9 440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c), 441.51 (5) (a) 5., and 448.980 (5) (b) 3., the department or a credentialing board may not require that an applicant for a credential or a credential holder be fingerprinted or submit fingerprints in connection with the department's or the credentialing board's credentialing.

AB500,17 Section 17 . 440.15 of the statutes, as affected by 2015 Wisconsin Act 116, section 12m, and 2017 Wisconsin Act .... (this act), is repealed and recreated to read:

AB500,7,16 440.15 No fingerprinting. Except as provided under ss. 440.03 (13) (c) and 441.51 (5) (a) 5., the department or a credentialing board may not require that an applicant for a credential or a credential holder be fingerprinted or submit fingerprints in connection with the department's or the credentialing board's credentialing.

AB500,18 Section 18 . 441.06 (1c) of the statutes is created to read:

AB500,7,23 441.06 (1c) The board shall grant a multistate license, as defined in s. 441.51 (2) (h), to an applicant for a multistate registered nurse license under s. 441.51. Subject to s. 441.07 (1g), the requirements under sub. (1) shall apply to such an applicant, except that the requirements under s. 441.51 (3) (c) for granting a multistate license shall supersede the requirements under sub. (1) to the extent of any conflict.

AB500,19 Section 19. 441.06 (4) of the statutes is amended to read:

AB500,8,10 441.06 (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 person registered nurse who is licensed to practice nursing 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. 441.50 441.51.

AB500,20 Section 20 . 441.10 (1c) of the statutes is created to read:

AB500,8,17 441.10 (1c) The board shall grant a multistate license, as defined in s. 441.51 (2) (h), to an applicant for a multistate licensed practical nurse license under s. 441.51. Subject to s. 441.07 (1g), the requirements under sub. (1) shall apply to such an applicant, except that the requirements under s. 441.51 (3) (c) for granting a multistate license shall supersede the requirements under sub. (1) to the extent of any conflict.

AB500,21 Section 21. 441.10 (7) of the statutes is amended to read:

AB500,9,7 441.10 (7) No license is required for practical nursing, but, except as provided in s. 257.03, no person without a license may hold himself or herself out as a licensed practical nurse or licensed attendant, use the title or letters “Trained Practical Nurse" or “T.P.N.", “Licensed Practical Nurse" or “L.P.N.", “ Licensed Attendant" or “L.A.", “Trained Attendant" or “T.A.", or otherwise seek to indicate that he or she is a licensed practical nurse or licensed attendant. No licensed practical nurse or licensed attendant may use the title, or otherwise seek to act as a registered, licensed, graduate or professional nurse. Anyone violating this subsection shall be subject to the penalties prescribed by s. 441.13. The board shall grant without examination a license as a licensed practical nurse to any person who was on July 1, 1949, a licensed attendant. This subsection does not apply to any person licensed practical nurse who is licensed to practice practical nursing 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. 441.50 441.51.

AB500,22 Section 22. 441.115 (2) (a) of the statutes is amended to read:

AB500,9,17 441.115 (2) (a) In this subsection, “nursing credential" means a license, permit or certificate of registration or certification that is granted to a person by another state or territory or by a foreign country or province and that authorizes or qualifies the person holding the credential to perform acts that are substantially the same as those performed by a person licensed as a registered nurse or licensed practical nurse under this subchapter. In this paragraph, “state or territory" excludes any state or territory that has adopted the nurse licensure compact under, except that “nursing credential” does not include a multistate license, as defined in s. 441.51 (2) (h), issued by a party state, as defined in s. 441.50 441.51 (2) (k).

AB500,23 Section 23. 441.15 (3) (a) (intro.) of the statutes is amended to read:

AB500,9,23 441.15 (3) (a) (intro.) Subject to s. 441.07 (1g), the board shall grant a license to engage in the practice of nurse-midwifery to any person registered nurse who is licensed as a registered nurse under this subchapter or who holds a multistate license, as defined in s. 441.51 (2) (h), issued in a party state, as defined in s. 441.50 441.51 (2) (j) (k), who does all of the following:

AB500,24 Section 24 . Subchapter II (title) of chapter 441 [precedes 441.50] of the statutes is amended to read:

AB500,10,1 CHAPTER 441

AB500,10,3 SUBCHAPTER II ENHANCED NURSE LICENSURE COMPACT

AB500,25 Section 25. 441.50 of the statutes is repealed.

AB500,26 Section 26. 441.51 of the statutes is created to read:

AB500,10,7 441.51 Enhanced nurse licensure compact. (1) Article I — Findings and declaration of purpose. (a) The party states find all of the following:

AB500,10,10 1. That the health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws.

AB500,10,12 2. That violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public.

AB500,10,16 3. That the expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation.

AB500,10,18 4. That new practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex.

AB500,10,20 5. That the current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states.

AB500,10,22 6. That uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits.

AB500,10,23 (b) The general purposes of this compact are as follows:

AB500,10,24 1. To facilitate the states' responsibility to protect the public's health and safety.

AB500,11,2 2. To ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation.

AB500,11,4 3. To facilitate the exchange of information between party states in the areas of nurse regulation, investigation, and adverse actions.

AB500,11,6 4. To promote compliance with the laws governing the practice of nursing in each jurisdiction.