CR 15-099 Rule Text

Statutory authority: ss. 15.08 (5) (b), and 441.01 (3), Stats.

Explanation of agency authority:

Each examining board shall promulgate rules for its own guidance and for the guidance of the profession to which it pertains and define and enforce professional conduct and unethical practices not inconsistent with the law relating to the particular profession. s. 15.08 (5) (b)

The board may establish minimum standards or schools for professional nurses and schools for licensed practical nurses, including all related clinical units and facilities, and make and provide periodic surveys and consultations to such schools. It may also establish 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. s. 441.01(3), Stats.

Related statute or rule: n/a

Plain language analysis:

The Board updated the current renewal chapter to reflect current practices and remove outdated references. The Board also updated the standards of practice chapter to current nursing practice standards.

Sections 1 and 2 repeal the current chapter 5 relating to renewal and creates a new subchapter in Chapter 2. The placement of the renewal and reinstatement provisions as a subsection of the chapter on licensure makes sense as it relates to licensure. This section clarifies that a person who has an expired license may not reapply for a new credential under the initial application process. A person renewing a license within 5 years is required to pay a renewal fee, any late fees and the workforce survey fee and complete the workforce survey. A person renewing after 5 years is required to pay the renewal fee, late fee, and workforce survey fee and evidence of employment requiring a nursing license within the last five years or complete a nursing refresher course. A person who failed to renew a credential within 5 years with unmet disciplinary requirements or has a license which has been surrendered or revoked may apply for reinstatement by showing evidence of rehabilitation or change in circumstances, completing any unfilled disciplinary requirements and if the person has not had an active license in the past five years complete the requirements for renewal beyond 5 years. If a license has been revoked, the person’s license may not be reinstated earlier than one year following revocation.

Section 3 renumbers the definition of “basic nursing care” in order to make room alphabetically for a new definition.

Section 4 creates a definition for “advanced practice nurse prescriber”. An advanced practice nurse prescriber is a registered nurse who holds an advanced practice nurse prescriber certificate.

Section 5 repeals the definition of “delegated medical act”.

Section 6 repeals the definition of “delegated nursing act” and creates a definition of “delegated act”. A delegated act is an act delegated to a registered nurse or license practical nurse.

Section 7 creates a definition of “provider”. A provider is a physician, podiatrist, dentist, optometrist or advanced practice nurse prescriber.

Section 8 updates the definitions to reflect a R.N. or L.P.N. includes those who have the privilege to practice in Wisconsin under the Nurse Licensure Compact.

Sections 9 and 10 updates the delegated acts terminology by removing the references to medical and nursing acts, uses the term provider instead of listing the various professions and updates the formatting to current drafting style.

Section 11 updates to current drafting style by adding “do all of the following:”

Section 12 updates the delegated acts terminology.

Section 13 updates to current drafting style.

Section 14 repeals and recreates a provision for an LPN to accept the charge nurse position in a nursing home only if prepared to do so based upon education, training and experience. The rewording of this provision is to provide more clarity.

Summary of, and comparison with, existing or proposed federal regulation: None

Comparison with rules in adjacent states:

Illinois: A license within 5 years of expiration is renewed by paying a fee and completion of 20 hours of continuing education. After 5 years a license is renewed by evidence of active practice in another state and completion of an approved licensure examination. A LPN accepts delegated acts from a RN, APN, or a physician assistant, physician, dentist or podiatrist. A delegated act, to or by an RN, is not distinguished as a medical or nursing delegated act. Practice as a RN means the full scope of nursing for which the registered nurse is properly trained.

Iowa: A license is renewed by paying a fee, attesting that Iowa is the primary state of residence and completion of continuing education and mandatory reporter training. RN minimum standards do not include practices ascribed to the advanced registered nurse practitioner. In executing the medical regimen prescribed, the RN shall notify the physician. A RN may delegate nursing tasks. An LPN shall perform services under the supervision of a RN or physician and may not perform any activity requiring the knowledge and skill ascribed to a RN.

Michigan: A license is renewed by payment of paying fees and completion of continuing education. Only a RN may delegate nursing acts, functions or tasks.

Minnesota: A license is renewed by paying a fee and completion of continuing education. Minnesota has a definition of delegation referring to the transfer of authority to another nurse or competent, unlicensed assistive person to perform a specific nursing task or activity in a specific situation. A LPN performs nursing standards at the direction of a registered nurse, advanced practice registered nurse or other licensed health care provider. A RN performs nursing standards recognized by the board. A RN receives delegations from a licensed health care provider and delegates nursing tasks. There is not a definition for health care provider.

Summary of factual data and analytical methodologies:

The Board conducted a comprehensive review and updated the renewal and standards of practice chapters in order to bring them up-to-date with current practice.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact analysis:

This rule was posted for economic comments and none were received.

Fiscal Estimate and Economic Impact Analysis:

The Fiscal Estimate and Economic Impact Analysis is attached.

Effect on small business:

These proposed rules do not have an economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department’s Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency contact person:

Sharon Henes, Administrative Rules Coordinator, Department of Safety and Professional Services, Division of Board Services, 1400 East Washington Avenue, Room 151, P.O. Box 8366, Madison, Wisconsin 53708; telephone [phone]; email at [e-mail].

TEXT OF RULE

Section 1. Subchapter V of N 2 is created to read:

SUBCHAPTER V

RENEWAL

N 2.40 Renewal. (1) General. A person with an expired credential may not reapply for a credential using the initial application process.

(2) Renewal within 5 years. A person renewing the credential within 5 years shall do all of the following:

(a) Pay the renewal fee as determined by the department under s. 440.03(9)(a), Stats. and any applicable late renewal fee.

(b) Pay a nursing workforce survey fee.

(c) Complete the nursing workforce survey to the satisfaction of the board.

(3) Renewal after 5 years. This subsection does not apply to credential holders who have unmet disciplinary requirements or whose credential has been surrendered or revoked. A person renewing the credential after 5 years shall do all of the following:

  (a) Pay the renewal fee as determined by the department under s. 440.03(9)(a), Stats. and the late renewal fee.